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Tytuł:
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Patient-Directed Home Drain Removal in Head and Neck Surgery.
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Autorzy:
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Sethia R; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Freeman T; College of Medicine, The Ohio State University, Columbus, Ohio, U.S.A.
Mead K; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Selhorst A; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Vala K; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Skoracki L; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Adelman M; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
VanKoevering K; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Kang SY; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Ozer E; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Agrawal A; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Old MO; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Carrau RL; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Rocco JW; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
Seim NB; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, U.S.A.
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Źródło:
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The Laryngoscope [Laryngoscope] 2021 Nov; Vol. 131 (11), pp. 2471-2477. Date of Electronic Publication: 2021 Apr 13.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: <2009- >: Philadelphia, PA : Wiley-Blackwell
Original Publication: St. Louis, Mo. : [s.n., 1896-
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MeSH Terms:
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Device Removal/*adverse effects
Drainage/*instrumentation
Home Care Services/*statistics & numerical data
Neck Dissection/*methods
Patient Discharge/*standards
Postoperative Care/*instrumentation
COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/transmission ; COVID-19/virology ; Device Removal/economics ; Drainage/methods ; Efficiency ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hematoma/epidemiology ; Hematoma/etiology ; Home Care Services/trends ; Humans ; Infections/epidemiology ; Infections/etiology ; Male ; Middle Aged ; Neck Dissection/statistics & numerical data ; Patient Education as Topic/standards ; Patient Education as Topic/trends ; Postoperative Care/statistics & numerical data ; Prospective Studies ; SARS-CoV-2/genetics ; Safety ; Seroma/epidemiology ; Seroma/etiology ; Time Factors
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References:
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Go BC, Brewster R, Patel R, Rajasekaran K. Using telemedicine and infographics for physician-guided home drain removal. OTO Open 2020;4 1-6.
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Harris T, Doolarkhan Z, Fagan JJ. Timing of removal of neck drains following head and neck surgery. Ear Nose Throat J 2011;90:186-189.
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Amir I, Morar P, Belloso A. Postoperative drainage in head and neck surgery. Ann R Coll Surg Eng 2010;92:651-654.
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Philips R, Seim N, Matrka L, et al. Cost savings associated with an outpatient otolaryngology telemedicine clinic. Laryngoscope Investig Otolaryngol 2019;4:234-240.
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Stossel LM, Segar N, Gliatto P, Fallar R, Karani R. Readability of patient education materials available at the point of care. J Gen Intern Med 2012;27:1165-1170. https://doi.org/10.1007/s11606-012-2046-0.
Qualliotine JR, Orosco RK. Self-removing passive drain to facilitate postoperative care via telehealth during the COVID-19 pandemic. Head Neck 2020 Jun;42:1305-1307.
Nouraei SA, Middleton SE, Hudovsky A, et al. A national analysis of the outcome of major head and neck cancer surgery: implications for surgeon-level data publication. Clin Otolaryngol 2013 Dec;38:502-511. https://doi.org/10.1111/coa.12185.
McMahon JD, MacIver C, Smith M, et al. Postoperative complications after major head and neck surgery with free flap repair-prevalence, patterns, and determinants: a prospective cohort study. Br J Oral Maxillofac Surg 2013 Dec;51:689-695. https://doi.org/10.1016/j.bjoms.2013.04.015.
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Grant Information:
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the James; the Triological Society
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Contributed Indexing:
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Keywords: COVID-19; Home drain removal; head and neck surgery; social distancing
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Entry Date(s):
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Date Created: 20210413 Date Completed: 20211020 Latest Revision: 20211020
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Update Code:
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20240104
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DOI:
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10.1002/lary.29556
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PMID:
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33847392
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Objectives/hypothesis: The purpose of this study was to evaluate the efficacy and safety of at home drain removal in head and neck surgery patients.
Methods: The study population included patients who underwent head and neck surgery at an academic tertiary care center between February 2020 and November 2020 and were discharged with one to four drains with instructions for home removal. Prior to discharge, patients received thorough drain removal education. Patients were prospectively followed to evaluate for associated outcomes.
Results: One hundred patients were evaluated in the study. There was record for ninety-seven patients receiving education at discharge. The most common methods of education were face-to-face education and written instructions with educational video link provided. Of 123 drains upon discharge, 110 drains (89.4%) were removed at home while 13 (10.6%) were removed in office. Most drains were located in the neck (86.4%). There was one seroma, two hematomas, two drain site infections, and five ED visits; however, none of these complications were directly associated with the action of drain removal at home. Calculated cost savings for travel and lost wages was $259.82 per round trip saved.
Conclusions: The results demonstrate that home drain removal can provide a safe and efficacious option for patients following head and neck surgery. This approach was safe and associated with patient cost savings and better utilization of provider's time. Furthermore, patients and healthcare providers avoided additional in-person encounters and exposures during the COVID-19 pandemic. Our findings warrant further investigation into cost savings and formal patient satisfaction associated with home drain removal.
Level of Evidence: 4 Laryngoscope, 131:2471-2477, 2021.
(© 2021 The American Laryngological, Rhinological and Otological Society, Inc.)
