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Early oral intake after reconstruction with a free flap for cancer of the oral cavity

  • Alice K. Guidera
    Affiliations
    Head & Neck and Skull Base Surgery/Oncology Programme, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Private Bag 31-907, High St, Lower Hutt, New Zealand
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  • Bronwen N. Kelly
    Affiliations
    Head & Neck and Skull Base Surgery/Oncology Programme, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Private Bag 31-907, High St, Lower Hutt, New Zealand
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  • Paul Rigby
    Affiliations
    Head & Neck and Skull Base Surgery/Oncology Programme, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Private Bag 31-907, High St, Lower Hutt, New Zealand
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  • Craig A. MacKinnon
    Affiliations
    Head & Neck and Skull Base Surgery/Oncology Programme, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Private Bag 31-907, High St, Lower Hutt, New Zealand
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  • Swee T. Tan
    Correspondence
    Corresponding author at: Head & Neck and Skull Base Surgery/Oncology Programme, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Private Bag 31-907, High St, Lower Hutt, New Zealand. Tel.: +64 4 587 2506; fax: +64 4 587 2510.
    Affiliations
    Head & Neck and Skull Base Surgery/Oncology Programme, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Private Bag 31-907, High St, Lower Hutt, New Zealand

    Gillies McIndoe Research Institute, Wellington, New Zealand
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      Abstract

      To allow healing of the surgical wound patients are traditionally given nothing by mouth for 6–12 days after resection and reconstruction of a cancer of the oral cavity. Our aim was to assess the impact of introducing oral intake within 6 days postoperatively. Consecutive patients who had resection and reconstruction of a cancer of the oral cavity with a free flap within an 8-year period were selected from the head and neck database. Personal and social data; type, stage, and site of the tumour; type of resection and free flap; postoperative complications; and duration of hospital stay were recorded, supplemented by review of casenotes for the time that oral intake was started, duration of nasogastric and tracheostomy intubation, and changes in body weight. Patients in the early oral intake group started oral intake within 5 days postoperatively, and those in the late group began feeding from postoperative day 6. The duration of hospital stay in the early group was significantly shorter than that in the late group. There was, however, no difference in the morbidity, including orocutaneous fistula, between the two groups. The duration of nasogastric and tracheostomy intubation was shorter, and weight loss was less, in the early group than in the late group, but not significantly so. Early oral feeding does not increase the morbidity for patients having resection and reconstruction with free flaps for cancers of the oral cavity. Early oral intake is associated with a shorter hospital stay, and this may have implications for improved postoperative outcome.

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