Our Summary

This research paper compares the costs, profits, and length of stay for different surgical methods used to reconstruct the tongue after cancer surgery in Germany in the past decade. Specifically, it looks at the use of split-thickness skin grafts (with and without tracheotomy) and microvascular reconstruction with a radial forearm flap.

The study found that the average length of stay in the hospital has decreased over the period. Also, until 2011, the reimbursement (money received from insurance or government) for all options was similar. But after 2012, the amount of money made for the microvascular reconstruction option almost doubled due to changes in Germany’s system for calculating hospital payments.

Even though this option had the highest costs, it also had the highest profits. However, the study warned that the longer operation times, intensive care, and longer hospital stay associated with this complex operation can easily turn profits into losses when compared to the quicker and simpler skin grafting procedure.

The study concludes that while the choice of surgical method should primarily be based on what is best for the patient, surgeons should also be aware of the financial risks of each procedure.

FAQs

  1. What surgical methods for tongue reconstruction after cancer surgery were compared in this research study?
  2. How have the costs, profits, and length of hospital stay for these surgical methods changed over the past decade in Germany?
  3. What are the financial implications for surgeons when choosing a surgical method for tongue reconstruction?

Doctor’s Tip

A doctor might tell a patient undergoing skin graft surgery to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include keeping the graft site clean and dry, avoiding strenuous activities that could put strain on the graft, and attending follow-up appointments to monitor progress. Additionally, the patient should be aware of signs of infection, such as increased redness, swelling, or pain at the site, and seek medical attention if any concerning symptoms develop.

Suitable For

Patients who typically undergo skin graft surgery are those who have suffered severe burns, traumatic injuries, or surgical removal of skin due to cancer or other medical conditions. Skin graft surgery may also be recommended for patients with chronic wounds that have not healed properly. Additionally, skin grafts may be used in cosmetic procedures to improve the appearance of scars or skin imperfections. Overall, skin graft surgery is recommended for patients who require skin replacement or reconstruction to improve function, appearance, or quality of life.

Timeline

Before skin graft surgery:

  1. Consultation with a surgeon to discuss the need for skin graft surgery and the different options available.
  2. Preoperative preparation, which may include blood tests, imaging tests, and stopping certain medications.
  3. Administration of anesthesia on the day of surgery.
  4. The surgeon removes damaged or diseased skin and prepares the area for the skin graft.
  5. The skin graft is harvested from another part of the body or from a donor.
  6. The skin graft is carefully placed and secured over the prepared area.
  7. The patient is monitored for any complications during recovery.

After skin graft surgery:

  1. Postoperative care, including monitoring for infection, pain management, and wound care.
  2. The patient may need to stay in the hospital for a few days to monitor the graft’s success and ensure proper healing.
  3. Follow-up appointments with the surgeon to monitor the healing progress and remove any stitches or dressings.
  4. Physical therapy or rehabilitation to help regain function and mobility in the affected area.
  5. Long-term follow-up to monitor for any complications or issues with the skin graft.

Overall, the timeline for skin graft surgery can vary depending on the individual patient’s condition and the extent of the surgery. It is important for patients to follow their surgeon’s recommendations for preoperative and postoperative care to ensure the best possible outcome.

What to Ask Your Doctor

  1. What are the different options for reconstructing the tongue after cancer surgery, including split-thickness skin grafts and microvascular reconstruction with a radial forearm flap?

  2. What are the potential risks and benefits associated with each surgical method?

  3. How long is the recovery process for each type of surgery, and what can I expect in terms of post-operative care?

  4. How will the choice of surgical method impact the length of my hospital stay?

  5. What are the costs associated with each surgical method, including potential out-of-pocket expenses and insurance coverage?

  6. Can you provide information on the success rates and long-term outcomes of each surgical option?

  7. Are there any specific factors about my medical history or current health status that may make me a better candidate for one type of surgery over another?

  8. What are the potential complications or side effects that I should be aware of before undergoing skin graft surgery?

  9. How will the choice of surgical method impact my quality of life after surgery, including speech and swallowing function?

  10. Are there any other alternative treatment options or additional resources that I should consider before making a decision about skin graft surgery?

Reference

Authors: Hoefert S, Lotter O. Journal: Clin Oral Investig. 2018 May;22(4):1741-1750. doi: 10.1007/s00784-017-2269-x. Epub 2017 Nov 9. PMID: 29124365