BACKGROUND: Reconstructive surgery for floor-of-mouth (FOM) resections presents unique challenges. Delaying oral feeding is hypothesised to reduce surgical complications. This study explores the relationships between surgical resection extent, free flap reconstruction, feeding practices, and nutritional outcomes. STUDY DESIGN: An observational study was conducted on patients with oral cavity reconstruction after oncological resections at a tertiary Australian Hospital. METHOD: Patients were grouped by extent of resection (EOR): non-FOM, close FOM, extended FOM, and segmental mandibulectomies. Univariate analyses compared complication rates, feeding regimens, and nutritional outcomes. RESULTS: EOR significantly affected the timing of feeding commencement (p = 0.044). Morbidity increased with EOR (p = 0.001) and was associated with the type of reconstruction (p = 0.002). There was no significant correlation between EOR and changes in BMI (p = 0.40) or postoperative serum albumin (p = 0.60). CONCLUSION: Feed commencement post-reconstructive surgery was influenced by surgical complexity. Complex surgeries were associated with increased complications but did not affect nutritional status.
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