title: [Microsurgical reconstruction and full management of patients with head and neck cancer: importance of a quality approach and a patient care team].
abstract: MAIN OF STUDY: Management and surgical reconstruction of head and neck cancers remain a challenge. From the first consultation to surgery and radiotherapy it is necessary to gain time to ensure optimum treatment and better survival rates.
  
  
  OBJECTIVE
  To establish a kind of quality approach to the management of patients with head and neck cancers. 54 patients who received microsurgical reconstruction after head and neck cancer were included in this study between 1997 and 2006.
  
  
  RESULTS
  Multiple data were considered: body mass index (BMI), ASA stage, age, existence of a pre-or postoperative radiotherapy, the surgeon's experience and the number of drainage veins. The success rate is superior when more than one draining vein is sutured to the flap for patients with a BMI >20. Radiotherapy does not seem to affect the survival of the flap.
  
  
  CONCLUSIONS
  According to current literature, the survival rate of these patients is better when the overall time care is less than 100 days. That period is possible with a perfect organization of the medical and paramedical team. Therefore, we propose to include these patients in a circuit protocolisation care, which saves time, to better inform patients and improve survival rates.
authors.affiliation: Centre Alexis Vautrin, Unité de Chirurgie cervico-faciale, département de Chirurgie oncologique, Avenue de Bourgogne, Brabois, 54511 Vandoeuvre les Nancy Cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Gisquet
authors.forename: P
authors.initials: P
authors.lastname: Gangloff
authors.forename: P
authors.initials: P
authors.lastname: Graff
authors.forename: B
authors.initials: B
authors.lastname: Phulpin
authors.forename: S
authors.initials: S
authors.lastname: Cortese
authors.forename: A
authors.initials: A
authors.lastname: Deganello
authors.forename: R
authors.initials: R
authors.lastname: Mastronicolaa
authors.forename: F
authors.initials: F
authors.lastname: Guillemin
authors.forename: L J
authors.initials: LJ
authors.lastname: Verhaeghe
authors.forename: G
authors.initials: G
authors.lastname: Dolivet
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004322:Drainage; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010348:Patient Care Team; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D013524:Surgical Flaps