Fast-track Orthognathic Surgery: An Evidence-based Review

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Protocols
• Patient Recovery

Background:

• Fast-track surgery (FTS) is a multidisciplinary approach optimizing patient management for rapid recovery and early discharge.
• FTS positively influences healthcare referral patterns and reduces system expenses.
• Minimizing presurgical stress and postsurgical discomfort is key to successful FTS.

Purpose of the Study:

• To establish an evidence-based, fast-track protocol for bimaxillary orthognathic surgery (OGS).
• To enhance patient recovery, satisfaction, and reduce hospital stay.
• To provide a protocol for future prospective studies and comparisons.

Main Methods:

• Conducted a literature review of Medline, Embase, and Cochrane Library (Jan 2000-July 2016).
• Utilized keywords: "fast track, enhanced recovery, multimodal, and perioperative care" for OGS protocol development.
• Performed evidence-based medicine searches for all protocol components.

Main Results:

• Developed a comprehensive OGS fast-track protocol.
• The protocol incorporates nonoperative and operative measures for improved patient outcomes.
• Identified measures to enhance patient satisfaction and decrease morbidity (nausea, headache, pain).

Conclusions:

• A fine-tuned fast-track protocol for uncomplicated OGS has been established.
• This protocol aims to improve patient outcomes, satisfaction, and reduce hospital stay.
• The protocol is ready for prospective study against current practices.