Complications in Neck Dissection

Olofsson, Jan; Tytor, Maciej

doi:10.1159/000275757

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…About 25 years ago, it was not unusual for patients to remain hospitalized for as long as 20 days following neck dissection. 6 Today, the strong trend toward shorter hospitalizations means that some patients are being discharged with drains in situ. Earlier drain removal could have a signifi cant impact on the duration of hospitalization and on the number of patients who are discharged with drains in situ.…”

Section: Discussionmentioning

confidence: 99%

Timing of Removal of Neck Drains following Head and Neck Surgery

2011

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Studies of the volume of drainage over a 24-hour period that is suffi cient to allow for the removal of a neck drain aft er head and neck surgery have not been reported, and thus the timing of drain removal varies among surgeons and institutions. We conducted a prospective study of 47 patients who had undergone major head and neck surgery to determine the safety and cost-eff ectiveness of removing a neck drain when the amount of drainage over a 24-hour period fell to 50 ml or less. When the volume reached that point in any given patient, the drain was clamped, and if no fl uid collection was observed the following day, the drain was removed. We found that drain removal according to this protocol was successful in 91% of cases, as only 4 patients (9%) developed a seroma following removal. No other complications were observed. In a separate analysis, we retrospectively reviewed the cases of 22 other patients who had undergone surgery at a diff erent institution. Th eir drains were not removed until the drainage volume fell to 25 ml over 24 hours. It took a median of 1.3 days (range: 1 to 3) for drainage to fall from 50 ml to less than 25 ml over 24 hours. We conclude that drains can be removed safely when the volume falls to 50 ml or less over a 24hour period. Th is would result in less morbidity, shorter hospital stays, and signifi cant cost savings.

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Section: Discussionmentioning

confidence: 99%

Timing of Removal of Neck Drains following Head and Neck Surgery

2011

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“…Most complications affect local tissue only and typically do not require additional hospitalization. 4,5 Placement of closed suction drains has been shown to minimize postoperative complications. 6 In recent decades, both clinical factors and economic pressures have led to streamlining of care in many surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Short Hospital Stay Following Neck Dissection

Tracy

Spiro²

2010

Arch Otolaryngol Head Neck Surg

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“…6,7 Likewise, 20 years ago average hospital stays of 10 to 20 days for neck dissections were not unusual. 2,3 In this study, we have evaluated our data on patients undergoing neck dissections with or without concomitant procedures to see whether sending patients home the day after surgery with closed suction drains is feasible. To our knowledge, no study to date has evaluated this care algorithm.…”

Section: Discussionmentioning

confidence: 99%

“…The most common postoperative complications involve the wound, including seromas, hematomas, flap breakdown, and so on. [2][3][4] The use of closed suction drain helps reduce these complications, and other authors advocate the maintenance of drains until the output is appropriately low. 5 These authors advocated the discharge of stable patients with the drain(s) after postoperative day 3.…”

mentioning

confidence: 99%