Early Post-operative Feeding: An Investigation of Early Functional Outcomes for Oral Cancer Patients Treated with Surgical Resection and Free Flap Reconstruction.
Grainne Brady, Lauren Leigh-Doyle, Francesco Riva and 2 others
PMID 34559292WHAT IT FOUND
Patients undergoing free flap reconstruction for oral cancer were seen by speech therapists on day one. 86% tolerated fluids, and median hospital stay was 10 days.
Fistula rates remained low at 10%, supporting early oral trials under clinical supervision.
Key findings
01The majority of patients tolerated oral fluids on day 1 post-operatively, progressing to pureed and soft moist diets during their stay.
02Median length of hospital stay was 10 days, which was shorter than historical averages at the centre.
03Orocutaneous fistula occurred in 10% of patients, with one resolving medically and two requiring surgical intervention after complications arose before oral intake.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Small cohort of only 29 patients with no control group for direct comparison. Single-site study, which may limit generalisability to other centres. Excluded patients with recurrent cancer. Relied on a single clinician-rated measure (PSS-NOD) rather than multidimensional patient-reported outcomes. Did not define the specific subtype of oral cavity tumours, which may affect fistula risk.
Declared interests
No specific funding sources or conflicts of interest are declared in the provided text.
The easy way to misread this
Do not conclude that early feeding caused the low fistula rate or short hospital stay. This study had no control group, so it cannot prove that early feeding is safer or more effective than delayed feeding. The 10-day stay and 10% fistula rate are descriptive outcomes of this specific protocol, not evidence of superiority.