Mathew Seema Alice, Senthilnathan P, Narayanan Vinod
Saveetha Dental College, No. 162, Poonamallee High Road, Velappanchavadi, Chennai, 600 077 India.
J Maxillofac Oral Surg. 2010 Dec;9(4):329-33. doi: 10.1007/s12663-010-0147-z. Epub 2011 Jan 18.
To assess the safety and efficacy of immediate postoperative management of major maxillofacial oncology patients in a High Dependency Unit (HDU).
All operated maxillofacial oncology patients were included. Detailed records and clinical parameters were assessed for diagnosis, procedure, diagnosis, American Society of Anaesthiologists (ASA) grade, procedure, type of reconstruction, duration of surgery, post operative location, days of hospitalization risk factors and complications if any.
All the patients were placed in a HDU care for 48 h for closed monitoring and thereafter were shifted to the head and neck general ward. Only 7/117 (6%) patients required ICU admission because of development of systemic complications. Of our cases, 108/117 made an uneventful recovery (92.3%) with no serious complications. We noted a correlation between the incidence of perioperative complications and risk factors of ASA status (χ(2) = 7.81, P = 0.005). Majority of the patients (94%) were managed successfully in the HDU care in the post operative period. Survival of free flaps proved to be extremely reliable with a survival rate of 99.1% (1/15 failed).
The routine use of a HDU care for 48 hours followed by shifting the patient to a maxillofacial head and neck general ward is more appropriate for management of post-operative maxillofacial oncology patients. This practice has helped in offering high quality, cost effective and efficient services without having any adverse effect on the quality of care.
评估在高依赖病房（HDU）对主要颌面肿瘤患者进行术后即刻管理的安全性和有效性。
纳入所有接受手术的颌面肿瘤患者。对详细记录和临床参数进行评估，内容包括诊断、手术、美国麻醉医师协会（ASA）分级、手术、重建类型、手术时长、术后安置地点、住院天数、危险因素以及是否存在并发症。
所有患者均在HDU接受48小时的密切监测，之后转至头颈普通病房。仅7/117（6%）例患者因出现全身并发症而需要入住重症监护病房（ICU）。在我们的病例中，108/117（92.3%）例患者恢复顺利，无严重并发症。我们注意到围手术期并发症的发生率与ASA状态的危险因素之间存在相关性（χ(2)=7.81，P=0.005）。大多数患者（94%）在术后HDU护理中得到成功管理。游离皮瓣的存活率被证明极其可靠，存活率为99.1%（1/15失败）。
对术后颌面肿瘤患者，常规在HDU护理48小时，然后将患者转至颌面头颈普通病房进行管理更为合适。这种做法有助于提供高质量、具有成本效益且高效的服务，而不会对护理质量产生任何不利影响。
