Advantages of not using the intensive care unit after operations for oropharyngeal cancer: An audit at Worcester Royal Hospital

Vascularized tissue transfer in head and neck surgery: Is intensive care unit–based management necessary?

“…Routine ICU care is presumed to contribute to a lower incidence of flap failure and postoperative complications. In our analysis, flap failure was comparable between groups (4.6% in the ICU group vs. 1.4% in the non‐ICU group) and to other contemporary studies . There was no increase in patients requiring a second operation on account of complications at the reconstructed or donor site.…”

Management of Post-Operative Maxillofacial Oncology Patients Without the Routine Use of an Intensive Care Unit

“…The rates of MRSA infection was less in the in the HDU admission patients in comparison to the patients who were send to the ICU and general head and neck ward in Worcester hospital [10]. This was because of relative isolation of the HDU patients in single side rooms for most of their postoperative stay and also because of the fact that they had not been previously admitted to ICU.…”

“…Admission to ICU has shown an increased incidence of MRSA infection [10]. The rates of MRSA infection was less in the in the HDU admission patients in comparison to the patients who were send to the ICU and general head and neck ward in Worcester hospital [10].…”

Immediate postoperative extubation in patients undergoing free tissue transfer

“…To et al suggested that in patients who did not undergo tracheotomy, extubation within 24 to 48 hours after surgery is a safe practice, and for patients with tracheostomies, postoperative mechanical ventilation and ICU admission are not necessary 6. McVeigh et al reported acceptable complication rates in a series of patients who had resections and reconstructions performed in a facility that only had a specialist unit and no ICU 7…”

“…As head and neck surgeons have become more comfortable and successful with the postoperative care of patients reconstructed with free flaps, greater attention is being given to the actual value of highly conservative approaches, such as prolonged postoperative intubation. There is evidence to show that the need for ICU admission in patients with FTT may be superfluous,4–7 and given that care in the ICU represents a large portion of the charges for inpatient care after FTT3 and puts patients at higher risk for certain complications such as nosocomial infections,9 bypassing the ICU altogether could improve cost‐effectiveness and patient safety. Given the observation at our institution that, on average, patients managed conservatively with prolonged postoperative intubation after FTT actually required mechanical ventilatory support for 12 hours longer than planned, we sought to evaluate the potential benefit and safety of immediate postoperative extubation.…”