There is considerable variation in the post-operative management of head and neck free flaps in the UK. We undertook a national postal survey of maxillofacial surgical units in the UK who perform free flap reconstruction following ablative head and neck surgery. Questions were asked about the routine postoperative care of a hypothetical, straightforward patient undergoing free flap reconstruction to determine whether there were any trends in managing these patients. There was considerable variation in the number of free flaps performed by each unit per year. The majority of patients (87%) are managed in either an intensive care or high dependency unit. The routine use of a tracheostomy is common (69%). There was also variation in the management of these cases, particularly with the requirement for ventilation. Few units routinely use dextran or dobutamine infusions, although one-to-one nursing and invasive cardiovascular monitoring are commonplace. Alternative provision of postoperative care is discussed.

译文

在英国,头颈部游离皮瓣的术后管理存在很大差异。我们对英国的颌面外科部门进行了全国邮政调查,这些部门在进行了头颈部消融手术后进行了游离皮瓣重建。询问了有关进行游离皮瓣重建的假设,直接的患者的常规术后护理的问题,以确定管理这些患者是否有任何趋势。每年每个单位执行的自由襟翼数量差异很大。大多数患者 (87%) 在重症监护或高依赖性病房中进行管理。气管切开术的常规使用是常见的 (69%)。这些病例的管理也有所不同,特别是在通风要求方面。尽管一对一的护理和侵入性心血管监测很普遍,但很少有单位常规使用右旋糖酐或多巴酚丁胺输注。讨论了术后护理的替代提供。

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