Close observation of the airway is a primary requirement for patients undergoing major head and neck surgery. It is also necessary for patients with upper airway infection and trauma. Wound care, drains, feeding and analgesia also require specific attention. Whilst these facilities are available in the ITU, availability of beds may be difficult and costs are high.
In this article the authors describe the setting of a high dependency postoperative unit in their hospital that receives such patients. The savings in cost amounted to over £80,000 in 18 months. One hundred and twenty-eight otolaryngology and maxillofacial surgery patients were admitted to this unit in 18 months and stayed for an average duration of two to three days, the occupancy rate being 31.7%.
The specially trained staff were deployed elsewhere when not required for this unit, thus avoiding wastage of resources. Relying on ITU not only increases costs but delays occur due to non-availability, sometimes leading to cancellation of routine work on the following day. A survey carried out by the authors showed there are seven such units in the country. This study shows it is easy to have these units and calls for more such units to be set up in the interest of safe and cost-effective care of patients subjected to several risks, most important of them all being postoperative airway obstruction.
