title: Cost-effectiveness of monitoring free flaps.
abstract: Methods of free flap monitoring have become more sophisticated and expensive. This study aims to determine the cost of free flap monitoring and examine its cost effectiveness. We examined a group of patients who had had free flaps to the head and neck over a two-year period, and combined these results with costs obtained from business managers and staff. There were 132 free flaps with a success rate of 99%. The cost of monitoring was Aus $193/flap. Clinical monitoring during this time period cost Aus$25 476 and did not lead to the salvage of any free flaps. Cost equivalence is reached between monitoring and not monitoring only at a failure rate of 15.8%. This is to our knowledge the first study to calculate the cost of clinical monitoring of free flaps, and to examine its cost-effectiveness.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's hospital, University of Queensland, Brisbane.
authors.forename: Shiva
authors.initials: S
authors.lastname: Subramaniam
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Brisbane and Women's hospital, University of Queensland, Brisbane.
authors.forename: David
authors.initials: D
authors.lastname: Sharp
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Brisbane and Women's hospital, University of Queensland, Brisbane.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jardim
authors.affiliation: Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's hospital, University of Queensland, Brisbane. Electronic address: batstonem@hotmail.com.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Batstone
mesh_terms: D003362:Cost-Benefit Analysis; D058752:Free Tissue Flaps / Q000191:economics*; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016879:Salvage Therapy
keywords: Cost effectiveness; Free flap; Monitoring; Success