1123 Incidence of Electrolyte Abnormalities in Patients Recovering Form Maxillofacial Resection and Free Flap Reconstruction

Abstract

Abstract Aim Recovery from resection of head and neck malignancy is fraught with potential complications. Among these are electrolyte disturbances. The majority of junior trainees in Oral & Maxillofacial surgery have qualified in dentistry and will have had little exposure to this topic. We aim to examine the incidence of disturbances in Serum Sodium, Potassium, Calcium, Magnesium and Phosphate. This information will aid in prioritising information for robust induction and educational programmes in Maxillofacial oncology centres. Method Patients were identified in a single centre from January to November 2022 from theatre records. All patients were adults who underwent resection for Head and Neck malignancy with free flap reconstruction. A total of 65 patients were included. The electronic pathology system was integrated for results. Results The most common abnormal result was hypophosphatemia (<0.8 mmol/L) present in 53 patients (81%). The next most common was hypocalcaemia (<2.2 mmol/L) which was present in on 46 patients (71%) Potassium imbalances were seen in fewer patients, with 10 being high (>5.3 mmol/L and 17 low (<3.5mmol/L). Least common were issues with Sodium, being high (>145mmol/L) for 9 patients (14%) and low (<135 mmol/L) for 14 patients (21%). Conclusions Electrolyte abnormalities are commonly encountered when caring for Maxillofacial Head & Neck cancer patients. Prior to surgery many patients have undergone a period of malnutrition due the pain. This makes them high risk of re-feeding syndrome once nutrition is started. Induction programmes should familiarise dental core trainees with the trust’s Re-feeding guidelines and when to escalate more severe problems.