title: Multicenter prospective micro-costing study evaluating mandibular free-flap reconstruction.
abstract: Free-flap mandibular reconstruction is a highly specialized procedure associated with severe complications necessitating re-interventions and re-hospitalizations. This surgery is expensive in terms of health workers' time, equipment, medical devices and drugs. Our main objective was to assess the direct hospital cost generated by osseocutaneous free-flap surgery in a multicentric prospective micro-costing study. Direct medical costs evaluated from a hospital perspective were assessed using a micro-costing method from the first consultation with the surgeon until the patient returns home, thus confirming the success or failure of the free-flap procedure. The mean total cost for free-flap intervention was 34,009€ (5151-119,604€), the most expensive item being the duration of hospital bed occupation, representing 30-90% of the total cost. In the event of complications, the mean cost increased by 77.3%, due primarily to hospitalization in ICU and the conventional unit. This surgery is effective and provides good results but remains highly complex and costly.
authors: Head and Neck Surgery, Centre Antoine Lacassagne, Institut Universitaire de la Face et du Cou, Nice, France.
authors: Olivier
authors: O
authors: Dassonville
authors: Head and Neck Surgery, Centre Antoine Lacassagne, Institut Universitaire de la Face et du Cou, Nice, France.
authors: Alexandre
authors: A
authors: Bozec
authors: Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189, Nice, France.
authors: Yann
authors: Y
authors: Château
authors: Maxillo-Facial Surgery, University Medical Center of Grenoble, Grenoble, France.
authors: Emile
authors: E
authors: Reyt
authors: Maxillo-Facial surgery, CHU Picardie, Amiens, France.
authors: Bernard
authors: B
authors: Devauchelle
authors: Maxillo-Facial Surgery, Centre Francois Baclesse Centre de Lutte Contre le Cancer, Caen, France.
authors: Marie-Yolande
authors: MY
authors: Louis
authors: Maxillo-Facial Surgery, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
authors: Pierre
authors: P
authors: Breton
authors: Head and Neck Surgery, Centre Oscar Lambret, Lille, France.
authors: Morbize
authors: M
authors: Julieron
authors: Maxillo-Facial Surgery, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France.
authors: Jacques
authors: J
authors: Yachouh
authors: Head and Neck Surgery, Centre Oscar Lambret, Lille, France.
authors: Yann
authors: Y
authors: Mallet
authors: Head and Neck Surgery, Institut Claudius Regaud, Toulouse, France.
authors: Jérôme
authors: J
authors: Sarini
authors: Université de Lorraine, CRAN UMR7039; CNRS, Vandœuvre-Lès-Nancy, France.
authors: Gilles
authors: G
authors: Dolivet
authors: Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189, Nice, France.
authors: Renaud
authors: R
authors: Schiappa
authors: Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189, Nice, France.
authors: Jocelyn
authors: J
authors: Gal
authors: Odontology, Centre Hospitalier Universitaire de Nice, Nice, France.
authors: Marie-Helene
authors: MH
authors: Orlanducci
authors: Head and Neck Surgery, Centre Antoine Lacassagne, Institut Universitaire de la Face et du Cou, Nice, France.
authors: Gilles
authors: G
authors: Poissonnet
authors: Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189, Nice, France. emmanuel.chamorey@nice.unicancer.fr.
authors: Emmanuel
authors: E
authors: Chamorey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005602:France; D058752:Free Tissue Flaps / Q000191:economics* / Q000637:transplantation; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation / Q000191:economics; D055815:Young Adult
keywords: Cost analysis; Free tissue flaps; Mandibular reconstruction; Multicenter study; Prospective studies