Free Flap Enhanced Recovery Protocols in Head and Neck Surgery

Logesvar Balaguru; Linda Chow; Matthew Mifsud; Allen Feng; Jeremy D Richmon; Diana Lobaina; Matthew O Old; Kiran Kakarala; Dustin Conrad; Peter Dziegielewski

doi:10.1016/j.fsc.2024.07.003

Free Flap Enhanced Recovery Protocols in Head and Neck Surgery

Facial Plast Surg Clin North Am. 2025 Feb;33(1):1-19. doi: 10.1016/j.fsc.2024.07.003. Epub 2024 Sep 17.

Authors

Affiliations

¹ Department of Otolaryngology, University of Florida, Gainesville, FL, USA.
² Department of Otolaryngology, University of South Florida, Tampa, FL, USA.
³ Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA.
⁴ Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
⁵ Department of Otolaryngology-Head and Neck Surgery, The Ohio State University College of Medicine, Columbus, OH, USA; Division of Head and Neck Cancer, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
⁶ Department of Otolaryngology-Head and Neck Surgery, University of Kansas, Kansas City, KS, USA.
⁷ Department of Otolaryngology, Division of Head & Neck Oncology and Microvascular Reconstructive Surgery, University of Florida, Gainesville, FL, USA.
⁸ Head & Neck Oncologic and Microvascular Reconstructive Surgery, Department of Otolaryngology, University of Florida, Gainesville, FL, USA. Electronic address: [email protected].

PMID: 39523030
DOI: 10.1016/j.fsc.2024.07.003

Abstract

Enhanced recovery after surgery (ERAS) protocols facilitates a standardized patient care regimen with a goal of reducing the metabolic stress of surgery. Adapted to head and neck free flap reconstructive surgery in 2017, these protocols focused on several key domains such as perioperative nutritional optimization, multimodal pain control, and early mobilization. Studies have shown that in addition to ERAS implementation, the maintenance and improvement of ERAS protocol compliance rates improve perioperative outcomes such as hospital length of stay and decrease major postoperative complications.

Keywords: ERAS; Enhanced recovery; Free flap reconstruction; Head and neck surgery; Length of stay; Perioperative care.

Publication types

Review

MeSH terms

Clinical Protocols
Early Ambulation
Enhanced Recovery After Surgery*
Free Tissue Flaps*
Head and Neck Neoplasms* / surgery
Humans
Perioperative Care / methods
Plastic Surgery Procedures* / methods
Postoperative Complications / etiology
Postoperative Complications / prevention & control