{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:44:47Z","timestamp":1790181887546,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the beneficial outcomes of intraoperative enteral feeding in free\u2010flap regeneration after extended head and\u00a0neck cancer resection and flap reconstruction surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A pilot randomized, double\u2010blind, placebo\u2010controlled clinical trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single tertiary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with advanced head and\u00a0neck cancers requiring radical tumor resections and free\u2010flap reconstruction were randomly assigned to receive intraoperative enteral nutrition feeding (100\u2009kcal\/100\u2009mL\u00a0at 10\u201020\u2009mL\/h) via a nasogastric tube during free\u2010flap reconstruction (n\u2009=\u200928) or continue fasting (n\u2009=\u200928). The primary outcome was impaired free\u2010flap regeneration that required surgical reintervention within 90 days after the operation. Participants were enrolled between April 2020 and January 2022; the 90\u2010day follow\u2010up ended in April 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of total or partial flap failure was similar between the 2 groups (14.2% or n\u2009=\u20094 in each group), but the rate of wound dehiscence or edge necrosis was significantly reduced in the feeding group (n\u2009=\u20096 vs 0 for fasting vs feeding; absolute risk reduction, 25.0% [95% confidence interval, 6.9\u201043.0]%; <jats:italic>p<\/jats:italic>\u2009=\u20090.022). Hospital stay length was shorter (<jats:italic>p<\/jats:italic>\u2009=\u20090.042) and hand grip strength was better preserved (<jats:italic>p<\/jats:italic>\u2009=\u20090.025) in the feeding group. Plasma concentrations of interleukin (IL)\u20106 and IL\u20108 after the operation increased significantly more in the fasting group. Perioperative adverse events did not differ between the 2 groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Perioperative enteral feeding is a simple, safe, and effective approach to improve perioperative systemic catabolism and proinflammatory reactions, thereby enhancing early wound regeneration after major operations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.335","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T05:42:25Z","timestamp":1679636545000},"page":"843-851","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Intraoperative Enteral Nutrition Feeding in Free\u2010Flap Healing after Reconstruction Surgery for Head and Neck Cancers"],"prefix":"10.1002","volume":"169","author":[{"given":"Tzer\u2010Zen","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, E\u2010Da Hospital I\u2010Shou University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, E\u2010Da Hospital I\u2010Shou University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seng\u2010Feng","family":"Jeng","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, E\u2010Da Hospital I\u2010Shou University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Chen","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Nutrition Therapy E\u2010Da Hospital and E\u2010Da Cancer Hospital  Kaohsiung Taiwan"},{"name":"Department of Nutrition I\u2010Shou University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu\u2010Shan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Research E\u2010Da Hospital and 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