Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction
Surgery with free flap reconstruction is a standard treatment for head and neck cancer (HNC). Because of the complexity of HNC surgery, recovery can be challenging, and complications are common. One of the foundations of enhanced recovery after surgery (ERAS) is early postoperative mobilization. The...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/13/12/2852 |
| _version_ | 1797531039703236608 |
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| author | Rosie Twomey T. Wayne Matthews Steven Nakoneshny Christiaan Schrag Shamir P. Chandarana Jennifer Matthews David McKenzie Robert D. Hart Na Li Khara M. Sauro Joseph C. Dort |
| author_facet | Rosie Twomey T. Wayne Matthews Steven Nakoneshny Christiaan Schrag Shamir P. Chandarana Jennifer Matthews David McKenzie Robert D. Hart Na Li Khara M. Sauro Joseph C. Dort |
| author_sort | Rosie Twomey |
| collection | DOAJ |
| description | Surgery with free flap reconstruction is a standard treatment for head and neck cancer (HNC). Because of the complexity of HNC surgery, recovery can be challenging, and complications are common. One of the foundations of enhanced recovery after surgery (ERAS) is early postoperative mobilization. The ERAS guidelines for HNC surgery with free flap reconstruction recommend mobilization within 24 h. This is based mainly on evidence from other surgical disciplines, and the extent to which mobilization within 24 h improves recovery after HNC surgery has not been explored. This retrospective analysis included 445 patients from the Calgary Head and Neck Enhanced Recovery Program. Mobilization after 24 h was associated with more complications of any type (OR = 1.73, 95% CI [confidence interval] = 1.16–2.57) and more major complications (OR = 1.76; 95% CI = 1.00–3.16). When accounting for patient and clinical factors, mobilization after 48 h was a significant predictor of major complications (OR = 2.61; 95% CI = 1.10–6.21) and prolonged length of stay (>10 days; OR = 2.85, 95% CI = 1.41–5.76). This comprehensive analysis of the impact of early mobilization on postoperative complications and length of stay in a large HNC cohort provides novel evidence supporting adherence to the ERAS early mobilization recommendations. Early mobilization should be a priority for patients undergoing HNC surgery with free flap reconstruction. |
| first_indexed | 2024-03-10T10:38:28Z |
| format | Article |
| id | doaj.art-d5bdf7073da04fd88e2aa4bd5c051732 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T10:38:28Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d5bdf7073da04fd88e2aa4bd5c0517322023-11-21T23:11:23ZengMDPI AGCancers2072-66942021-06-011312285210.3390/cancers13122852Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap ReconstructionRosie Twomey0T. Wayne Matthews1Steven Nakoneshny2Christiaan Schrag3Shamir P. Chandarana4Jennifer Matthews5David McKenzie6Robert D. Hart7Na Li8Khara M. Sauro9Joseph C. Dort10Ohlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaDepartments of Community Health Sciences, Surgery & Oncology University of Calgary Cumming School of Medicine, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaOhlson Research Initiative, Arnie Charbonneau Research Institute, University of Calgary Cumming School of Medicine, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, CanadaSurgery with free flap reconstruction is a standard treatment for head and neck cancer (HNC). Because of the complexity of HNC surgery, recovery can be challenging, and complications are common. One of the foundations of enhanced recovery after surgery (ERAS) is early postoperative mobilization. The ERAS guidelines for HNC surgery with free flap reconstruction recommend mobilization within 24 h. This is based mainly on evidence from other surgical disciplines, and the extent to which mobilization within 24 h improves recovery after HNC surgery has not been explored. This retrospective analysis included 445 patients from the Calgary Head and Neck Enhanced Recovery Program. Mobilization after 24 h was associated with more complications of any type (OR = 1.73, 95% CI [confidence interval] = 1.16–2.57) and more major complications (OR = 1.76; 95% CI = 1.00–3.16). When accounting for patient and clinical factors, mobilization after 48 h was a significant predictor of major complications (OR = 2.61; 95% CI = 1.10–6.21) and prolonged length of stay (>10 days; OR = 2.85, 95% CI = 1.41–5.76). This comprehensive analysis of the impact of early mobilization on postoperative complications and length of stay in a large HNC cohort provides novel evidence supporting adherence to the ERAS early mobilization recommendations. Early mobilization should be a priority for patients undergoing HNC surgery with free flap reconstruction.https://www.mdpi.com/2072-6694/13/12/2852head and neck cancerhead and neck surgerycare pathwaysclinical pathwaysenhanced recoveryearly mobilization |
| spellingShingle | Rosie Twomey T. Wayne Matthews Steven Nakoneshny Christiaan Schrag Shamir P. Chandarana Jennifer Matthews David McKenzie Robert D. Hart Na Li Khara M. Sauro Joseph C. Dort Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction Cancers head and neck cancer head and neck surgery care pathways clinical pathways enhanced recovery early mobilization |
| title | Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction |
| title_full | Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction |
| title_fullStr | Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction |
| title_full_unstemmed | Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction |
| title_short | Impact of Early Mobilization on Recovery after Major Head and Neck Surgery with Free Flap Reconstruction |
| title_sort | impact of early mobilization on recovery after major head and neck surgery with free flap reconstruction |
| topic | head and neck cancer head and neck surgery care pathways clinical pathways enhanced recovery early mobilization |
| url | https://www.mdpi.com/2072-6694/13/12/2852 |
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