Facial plastic surgery & aesthetic medicine
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Facial Plast Surg Aesthet Med · Jan 2021
Value of Intensive Care Unit-Based Postoperative Management for Microvascular Free Flap Reconstruction in Head and Neck Surgery.
Importance: Although routine postoperative care for microvascular free flap reconstruction typically involves admission to the intensive care unit (ICU), few studies have investigated the effect of postoperative care setting on clinical outcomes and institution cost. Objectives: To determine the value of non-ICU-based postoperative management for free tissue transfer for head and neck surgery, in terms of clinical outcomes and cost-effectiveness. Design, Setting, and Participants: This is a retrospective cohort study of two groups of adults who underwent vascularized free tissue transfer from October 2013 to October 2017 at an academic tertiary care center and community-based hospital, respectively. ⋯ However, average cost of care was significantly higher for patients who received ICU-based care versus non-ICU postoperative care. Specifically, room and board were 239% more costly for the planned ICU care group than the non-ICU setting (p < 0.00001). Conclusions and Relevance: This study demonstrates that postoperative management after vascularized free tissue transfer in a non-ICU setting is equivalent to standard ICU-based management, in terms of clinical outcomes, while being less costly.