Effect of Early Mobilization Program on Postoperative Complications after Head and Neck Reconstruction

Postoperative bed rest is prescribed to prevent vascular compromise in some patients who undergo free flap head and neck reconstruction. However, the effectiveness of bed rest for the prevention of vascular compromise is controversial, and longer rest increases the risk of postoperative delirium and pneumonia. Recently, we instituted an early mobilization program in the rehabilitation unit to shorten the hospital stay and reduce systemic complications. This study retrospectively evaluated the effects of an early mobilization program.
This study enrolled 44 patients who underwent free flap head and neck reconstruction between January 2016 and August 2017, and included 32 men and 12 women, with an average age of 65 years. Patients were divided into two groups, to compare the results before and after introduction of the early mobilization program. Postoperative complications, time to tracheal stoma closure, time to resume oral feeding, and postoperative hospital stay were compared between the two groups.
Thirty-one patients were evaluated before the early mobilization program and 13 were evaluated after the program. Patient background, postoperative complication rate, time to tracheal stoma closure, and time to resume oral feeding were not significantly different between the two groups. However, the average postoperative hospital stay was significantly shorter in patients enrolled in the early mobilization program (50 vs. 37 days, p=0.043).
Postoperative local complications were not increased after the introduction of the early mobilization program. The development of postoperative systemic complications was not affected by the program. However, patients who were enrolled in the early mobilization program had a shorter postoperative hospital stay.