The benefit of postoperative early ambulation after microvascular surgery for head and neck reconstruction

Postoperative bed rest has been used for patients who underwent microsurgical head and neck reconstructions to avoid the risk of a thrombosis at the microvascular anastomosis. However, prolonged bed rest increases the risk of postoperative complications such as deep vein thrombosis, pneumonia, atelectasis and delirium. We created a postoperative program in which early ambulation is started after microsurgery of head and neck reconstruction. In the first period, from September 2002 to September 2003, 45 cases underwent bed rest for 4 days and started ambulation at 5 days after microsurgery. In the second period, from October 2003 to September 2004, 47 cases underwent bed rest for 1 day and started ambulation at 2 days. In the third period, after October 2004, 164 cases did not need bed rest and started ambulation on the day after operation. The thrombosis rates at the vessel anastomosis in the first, second and third periods were 2.2%, 2.1% and 1.8%, and postoperative delirium rates in each period were 29%, 23% and 7%, respectively. We conclude that early ambulation decreased the postoperative delirium rate and did not affect the thrombosis rate after microvascular anastomosis for head and neck reconstruction.