S111 – Monitoring Frequency: A Determinant in Free Tissue Transfer

Abstract

Objectives 1) To compare the success rates of free tissue transfer (FTT) between a cohort of patients who underwent frequent scheduled checks to a cohort who received checks on an as-needed basis. 2) To compare the overall flap survival, ICU stay, in-hospital stay, complications, and cost. Methods Patients meeting the criteria for free tissue transfer were divided into 2 cohorts: minimal FTT monitoring and frequent scheduled FTT monitoring. In August 2005, frequent scheduled flap monitoring was instituted. The study was set up to identify if this method impacted overall patient outcomes. The 2 groups were compared over several dimensions: overall flap outcome, total vs. partial flap loss, length of stay in hospital, revision procedures, and complications. Results A total of 212 patients were identified. 107 of the patients were in the frequent, scheduled group and 105 were in the minimal group. The overall FTT success rates were significantly higher in the frequently scheduled group versus the minimal group (100% vs 89%). The rates of partial flap loss and total flap loss were higher in the minimal group (11% vs 4%). The overall length of stay in the hospital, length of stay in the ICU, and complication rates were nonsignificant between the 2 groups. However, the number of revision procedures were significantly lower in the frequently scheduled FTT group. Conclusions The implementation of frequent scheduled flap monitoring significantly improves free tissue transfer survival in head and neck patients and decreases the number of revision procedures that need to be performed.