RESOURCE UTILIZATION AND PATIENT MORBIDITY IN HEAD AND NECK RECONSTRUCTION

Many papers have addressed the technical aspects of free tissue transf er in head and neck cancer patients. However, there has not been a cri tical assessment of the impact of free tissue transfer on resource uti lization and patient morbidity compared with pedicle flap reconstructi ons. Two cohorts of patients derived from 245 consecutive reconstructi ons were tightly matched by age, site, stage, and histology, yielding 44 patient pairs differing in method of reconstruction. Patients under going free flap reconstruction spent more time in the operating room t han those reconstructed with pedicled flaps (993 min vs. 777 min, P < 0.0001). The group with free flap reconstruction spent fewer days in t he surgical intensive care unit and hospital (2 days vs. 2.5 days; 18. 5 days vs. 22.6 days). This difference is attributed to the paucity of postoperative complications in the group with free flap reconstructio n (fistula formation 4.5% vs. 21%, P < 0.04). These data indicate that the continued use of sophisticated reconstructive techniques in head and neck cancer patients is economically sound as assessed by patient morbidity and resource utilization.