Free flap - Discharge protocol

Neuro

• • Narcotic order and paper script

Pulm

• • PCC and Recuperative Skills - Clarify that all suctioning supplies and equipments are ordered and delivered for home

FEN

• Dietary consult - clarify nutritional and tube feeds needs 

  • PCC and Recuperative Skills - Clarify that all supplies and equipments are ordered and delivered for home

PPX

• Stop ASA 325 mg upon discharge

Wound

• Drain care education order

  • Request measuring cup for home

  • Include instructions in DCI

    • Please measure and record the output volume daily and bring the record with you to the follow up appointment

    • Please note any changes in the characteristics (color and consistency) of the drain output 

    • Please contact the HNS clinic immediately if you believe the drain is not functioning properly or you have another concern 

• Supplies

  • Measuring cup

  • Wound care dressings 

• STSG donor site

  • Tegaderm off site prior to discharge and leave open to air

  • Home/SNF wound care

    • Leave open to air during the day

    • Xeroform, telfa, kerlix at night

Consults

• Coordinate with PCC

  • Home PT as needed

  • Home health nursing as needed

Follow-up

• Clinic R30

  • 1-2 weeks after discharge with the operating attending or with resident/PA when the attending is around

• If the patient has an NG tube and intraoral resection/flap was performed, the ST team needs to be messaged to be at the f/u appointment as well

• Patient will have donor site cast and bolster taken down at first post-op clinic visit.