Abstract
Perioperative oral management is widely recognized in the healthcare system of Japan. Conventionally, the surgeon refers patients with oral problems to a dental or oral surgery clinic in the hospital. However, frequent in-house referrals were found to increase the number of incoming patients resulting in unsustainable situations due to an insufficient workforce. In 2011, the Center for Perioperative Medicine was established at our hospital to function as a management gateway for patients scheduled to undergo surgery under general anesthesia. The “oral triage” system, wherein a dental hygienist conducts an oral screening to select patients who need preoperative oral hygiene and functional management, was established in 2012. A total of 37,557 patients who underwent surgery at our hospital from April 2010 to March 2019 (two years before and seven years after introducing the system) were evaluated in this study. The sustainability and effectiveness of introducing the system were examined in 7715 cancer surgery patients. An oral management intervention rate of 20% and a significant decrease in the incidence of postoperative pneumonia (aOR = 0.50, p = 0.03) indicated that this system could be useful as a sustainable and developmental oral management strategy to manage surgical patients with minimal human resources.
Highlights
The development of minimally invasive surgical techniques has improved the chances of selecting an appropriate surgical treatment method, even in elderly patients with comorbidities
Among the several postoperative complications, such as wound infection and hemorrhage, the present study focused on postoperative pneumonia because it is known to be affected by poor oral hygiene [1]
Diseases of the digestive system were found to be most common pre- and post-introduction in the sample group, with the number of patients increasing in the order of cardiovascular, female genitalia, puerperal, respiratory, and nervous system diseases
Summary
The development of minimally invasive surgical techniques has improved the chances of selecting an appropriate surgical treatment method, even in elderly patients with comorbidities. Nishino et al [12] compared the incidence rates of postoperative pneumonia and the duration of hospitalization in 50 intervention and 50 non-intervention patients with primary lung cancer, and 30 intervention and 70 non-intervention patients with esophageal cancer after the introduction of perioperative oral management. Sotome et al conducted a multicenter retrospective study on the risk factors of postoperative pneumonia in 234 intervention and 149 non-intervention esophageal cancer patients [11]. They found that the execution of oral function management (aOR = 0.42) was significantly associated with the onset of postoperative pneumonia. To date, perioperative oral management is considered to be effective for the prevention of (postoperative) pneumonia after hospitalization in patients with malignant tumors of the stomach, esophagus, lung, and brain
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International journal of environmental research and public health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
