title: Management of post-operative maxillofacial oncology patients without the routine use of an intensive care unit.
abstract: OBJECTIVE
  To assess the safety and efficacy of immediate postoperative management of major maxillofacial oncology patients in a High Dependency Unit (HDU).
  
  
  METHODS
  All operated maxillofacial oncology patients were included. Detailed records and clinical parameters were assessed for diagnosis, procedure, diagnosis, American Society of Anaesthiologists (ASA) grade, procedure, type of reconstruction, duration of surgery, post operative location, days of hospitalization risk factors and complications if any.
  
  
  RESULTS
  All the patients were placed in a HDU care for 48 h for closed monitoring and thereafter were shifted to the head and neck general ward. Only 7/117 (6%) patients required ICU admission because of development of systemic complications. Of our cases, 108/117 made an uneventful recovery (92.3%) with no serious complications. We noted a correlation between the incidence of perioperative complications and risk factors of ASA status (χ(2) = 7.81, P = 0.005). Majority of the patients (94%) were managed successfully in the HDU care in the post operative period. Survival of free flaps proved to be extremely reliable with a survival rate of 99.1% (1/15 failed).
  
  
  CONCLUSIONS
  The routine use of a HDU care for 48 hours followed by shifting the patient to a maxillofacial head and neck general ward is more appropriate for management of post-operative maxillofacial oncology patients. This practice has helped in offering high quality, cost effective and efficient services without having any adverse effect on the quality of care.
authors.affiliation: Saveetha Dental College, No. 162, Poonamallee High Road, Velappanchavadi, Chennai, 600 077 India.
authors.forename: Seema Alice
authors.initials: SA
authors.lastname: Mathew
authors.forename: P
authors.initials: P
authors.lastname: Senthilnathan
authors.forename: Vinod
authors.initials: V
authors.lastname: Narayanan