A rapid recovery protocol for head and neck oncology patients undergoing resection, free flap reconstruction, and tracheostomy: a feasibility study

Abstract

Enhanced recovery after surgery (ERAS) for head and neck oncology patients was first introduced in 2017 and was found to improve patient outcomes, in line with results from other surgical specialties. This article presents a rapid recovery protocol (RRP) to further enhance perioperative care in conjunction with the ERAS protocol, for patients undergoing ablative surgery together with free flap reconstruction and tracheostomy. A prospective multidisciplinary approach was adopted to identify a specific cohort of patients who would benefit from the RRP. Of 26 patients who fulfilled the eligibility criteria, 16 completed the RRP. On average, these patients spent 5 days less with a tracheostomy and were discharged 7 days sooner when compared to a matched control group of nine patients on the standard postoperative care pathway. This resulted in an approximate monetary saving of £ 9955 per patient for the hospital trust. These results demonstrate that the feasibility study should be rolled out further, as the RRP not only decreased the length of stay but also provided substantial monetary savings without compromising patient outcomes.