Home Care after Oral Cavity Composite Resection
What is composite resection?
A composite resection surgery is done to
remove tumors of the floor of the mouth, the
tongue and/or jaw bone. Your surgeon may
also take out some of the lymph nodes in
your neck. One or more of your teeth may
need to be removed. The area may be
rebuilt with tissue from other parts of the
body. This tissue is called a flap or graft
and may be skin, fatty tissue with blood
vessels, muscle, cartilage and/or bone. The
area where the flap or graft is taken from is
called the donor site.
What to Expect
Expect to spend one or two nights in the
intensive care unit after surgery. You will
be transferred to the Ear Nose and Throat
inpatient unit for the rest of your hospital
Dressing and Drains
You can expect temporary drainage tubes on
the affected side of your neck and also at the
donor site. You will have dressings on your
face, neck and donor site.
You will have a lot of swelling inside your
mouth. To protect your airway (breathing),
your surgeon may do a temporary
Tracheostomy or “Trach” (trake) tube.
A small hole is made in the front of your
neck and a Tracheostomy tube is inserted
through this hole to help you breathe. You
may not be able to speak while you have the
tracheostomy. You will cough out
secretions through the tracheostomy tube.
The nurses will help you take care of it. The
tracheostomy tube may come out before you
leave the hospital.
In order for good healing your body needs
good nutrition. Swallowing will be hard
because of the swelling in your mouth. You
will have a small thin feeding tube in your
nose so you can get liquid nutrition and
medicines. The feeding tube can be taken
out as soon as you are able to eat on your
own. You may need a longer term feeding
tube placed in your stomach if you have
more trouble swallowing or if you need to
have chemotherapy or radiation.
Speech and Swallow
Your speech may also be affected by the
swelling in your mouth. We will have a
speech and swallow therapist work with you
If your flap or graft is taken from your leg
you may have some trouble walking on that
leg at first. A physical therapist will work
with you in the hospital.
If nerves have to be cut to remove the tumor
you may have some temporary or permanent
nerve damage. We may not know how
much nerve damage there is for a few
months after surgery. There can be some
numbness, tingling or decreased feeling in
the area of your surgery. You should be
careful around extremes of hot or cold. Be
very careful when using heating pads, ice
packs, razors and hair dryers.
You will be given pain medicine through
your IV at first, and then changed to liquid
pain medicine when you can swallow.
What to do at Home
For 2 weeks after you are home keep your
head raised 30 degrees when you lay down;
use 2-3 pillows. Do not sleep on the side
where you had your surgery.
ξ Avoid strenuous activity such as
jogging, aerobics, swimming or
lifting greater than 25 pounds for 2-4
weeks. Do not bend over so your
head is lower than your heart for 2
weeks. You may return to work
when your doctor says it is okay,
usually 4-6 weeks after surgery.
ξ Do not drive or drink alcohol while
you are taking narcotic pain
ξ When you are able to swallow well
you will progress your diet as you
are able to from liquids to soft foods.
Before you leave the hospital you will be
told how to care for any incision sites.
Watch for any signs of infection:
ξ Increased swelling
ξ Increased pain
ξ Pus-like drainage
ξ Warmth at the incision site
ξ Fever greater than 101 degrees
Do not take aspirin or other blood thinning
medicines until your doctor tells you that it
When to call
ξ Bleeding that soaks a gauze dressing
in 10 minutes or less
ξ Any sign of infection
ξ If the flap or graft looks pale white,
gray or black in color
ξ Pain not relieved by pain medicine
ξ Increased swelling of the head or
neck area, at the site of the flap or at
the donor site
ξ Trouble breathing; Call 911 or go to
the nearest Emergency Room
ξ Fever of 101 degrees or greater for
two readings taken 4 hours apart
ξ Any changes in facial movement;
facial droop on one side that wasn’t
present after surgery or is getting
Who Do I Call?
If you have any questions or problems once
you are at home, please call the ENT clinic
(608) 263-6190, weekdays from 8:00 am to
After hours and weekends, the paging
operator answers the clinic number. Ask for
the ENT resident on call. The resident will
return your call.
Our toll free number is 1-800-323-8942
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7702