• Curr Opin Otolaryngol Head Neck Surg · Oct 2017

    Review

    Perioperative care of head and neck free flap patients.

    • Michael R Kinzinger and Arnaud F Bewley.
    • aDepartment of Otolaryngology, University of California Davis bDivision of Head and Neck, Department of Otolaryngology, University of California Davis, Davis, California, USA.
    • Curr Opin Otolaryngol Head Neck Surg. 2017 Oct 1; 25 (5): 405-410.

    Purpose Of ReviewThis article reviews the recent literature on the perioperative care of head and neck surgical patients undergoing free tissue transfer.Recent FindingsAs the overall success of head and neck free flaps has plateaued above 95%, recent literature on perioperative flap management has focused on minimizing complications, length of stay, and cost of treatment. Current areas of research include preoperative risk stratification, preoperative and postoperative nutrition, intraoperative fluid management, postoperative level of care, postoperative antibiotic prophylaxis, defining the impact of comorbidities, and developing comprehensive evidence-based perioperative care protocols.SummaryRates of complications for head and neck free flap surgery remain stubbornly high. Optimization of perioperative nutrition, antibiotics, fluid management, and the establishment of structured pathways has the potential to decrease these complication rates. However, more research is needed into defining and implementing optimal comprehensive care regimens for this complex patient population.

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