title: No reduction in complication rate by stay in the intensive care unit for patients undergoing surgery for head and neck cancer and microvascular reconstruction.
abstract: BACKGROUND
  The aim of this prospective cohort study was to determine whether an immediate postoperative period of deep sedation and artificial respiration in an intensive care unit (ICU) leads to fewer complications and a reduced failure rate of microvascular flaps compared with a situation in which patients are allowed to breathe spontaneously without sedation in a recovery room.
  
  
  METHODS
  Each group comprised 50 patients. General medical complications and flap donor and recipient site complications were documented.
  
  
  RESULTS
  Significantly, more patients had problems with weaning from ventilation in the ICU group (p = .022). More cases of respiratory insufficiency (p = .240) and pneumonia (p = .081) occurred in the ICU group compared with the recovery room group without statistically significant differences. The number of flaps lost was comparable in both groups (p = .646).
  
  
  CONCLUSIONS
  Admission to an ICU did not reduce complications after microvascular reconstruction and, therefore, has only to be considered for selected cases.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. emeka.nkenke@uk-erlangen.de
authors.forename: Emeka
authors.initials: E
authors.lastname: Nkenke
authors.forename: Elefterios
authors.initials: E
authors.lastname: Vairaktaris
authors.forename: Florian
authors.initials: F
authors.lastname: Stelzle
authors.forename: Friedrich W
authors.initials: FW
authors.lastname: Neukam
authors.forename: Michael
authors.initials: M
authors.lastname: St Pierre
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003422:Critical Care; D054810:Deep Sedation; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012121:Respiration, Artificial; D013524:Surgical Flaps; D016896:Treatment Outcome