The team concept in mandibular reconstruction after ablative oncologic surgery

Purpose: This study evaluated the efficiency and cost-effectiveness of using a reconstructive team for mandibular reconstruction. Methods: An outcome-based retrospective review of 64 patients who had undergone microvascular fibular reconstruction of the mandible was performed. Operating room time, use of blood products, intraoperative fluid replacement, and hospital and intensive care unit stay were evaluated. Patients were divided into 2 groups on a chronologic basis. Group 1 was the first 34 consecutive patients and group 2 was the next 30 consecutive patients. Results: Group 2 had a significantly shorter operating room time (P < .0001), hospital stay (P = .012), and used significantly less blood (P = .002) and colloid (P = .044) than group 1, resulting in significant cost savings, ($5,061.47/patient). Analysis showed no differences between groups demographically or for wound complications. Conclusions: Experience and the development of a team concept significantly decreased the cost for mandibular reconstruction with free fibula flaps without increasing wound complications. (C) 2000 American Association of Oral and MaXillofacial Surgeons.