| Postoperative monitoring in free tissue transfer patients: effective use of nursing and resident staff. | |
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MedLine Citation:
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PMID: 19861201 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To compare the outcomes of two different free flap monitoring protocols and determine whether nursing staff can safely and effectively monitor free flaps. STUDY DESIGN: Historical cohort study on all head and neck free tissue transfer patients from August 2003 to August 2007. SETTING: Tertiary care teaching institution. SUBJECTS AND METHODS: The patients were divided into two groups according to monitoring protocol. Group A (n = 49) had free flaps monitored primarily by resident physicians, while Group B patients (n = 45) were evaluated primarily by nursing staff. Demographic and outcomes data, including complications, reoperations, length of hospital stay, and flap viability, were then compared. RESULTS: Overall, 28 (57%) patients in Group A and 16 (37%) in Group B had at least one complication (P = 0.05). Only eight patients in each group had major complications. There were 25 (27%) patients who required further intervention in the operating room: 18 (37%) in Group A and seven (16%) in Group B (P = 0.03). Only 12 (13%) patients returned to the operating room for concerns of flap viability: seven from Group A and five from Group B. The median length of hospital stay was 11 days for both groups (P = 0.76). The flap success rate was 95 percent, with three failures in Group A and two in Group B (P = 0.72). CONCLUSIONS: A monitoring protocol utilizing trained nursing staff has no detrimental effect on free tissue transfer outcomes. This may be used to optimize resident time within the current duty-hour restrictions. |
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Authors:
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Ryan S Jackson; Ronald J Walker; Mark A Varvares; Michael J Odell |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-09-06 |
Journal Detail:
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Title: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Volume: 141 ISSN: 1097-6817 ISO Abbreviation: Otolaryngol Head Neck Surg Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-28 Completed Date: 2009-11-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8508176 Medline TA: Otolaryngol Head Neck Surg Country: United States |
Other Details:
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Languages: eng Pagination: 621-5 Citation Subset: IM |
Affiliation:
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Saint Louis University School of Medicine, Saint Louis, MO, USA. jacksonr@slu.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Female Humans Internship and Residency* Length of Stay Male Middle Aged Monitoring, Physiologic / methods* Nursing Staff, Hospital / utilization* Postoperative Care / methods* Surgical Flaps* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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