Shi DD, Zhang M, Ding J, Tian J. Postoperative massive hemorrhage in oral cancer surgery nursing interventions and outcomes: A case report. World J Clin Cases 2025; 13(28): 109334 [DOI: 10.12998/wjcc.v13.i28.109334]
Corresponding Author of This Article
Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, No. 2 Sunwen East Road, Zhongshan 528400, Guangdong Province, China. tian-ju@163.com
Research Domain of This Article
Dentistry, Oral Surgery & Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Postoperative massive hemorrhage in oral cancer surgery nursing interventions and outcomes: A case report
Dan-Dan Shi, Meng Zhang, Jing Ding, Ju Tian
Dan-Dan Shi, Meng Zhang, Jing Ding, Department of Plastic Surgery, Zhongshan City People’s Hospital, Zhongshan 528400, Guangdong Province, China
Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, Zhongshan 528400, Guangdong Province, China
Co-first authors: Dan-Dan Shi and Meng Zhang.
Author contributions: Shi DD and Zhang M contributed equally to this manuscript and are co-first authors of this article. Shi DD, Zhang M, and Ding J contributed to writing and editing the manuscript, and reviewing the relevant literature; Tian J conceived and designed the overall concept and structure of the manuscript.
Supported by the First Batch of 2024 Social Welfare and Basic Research Projects in Zhongshan City (General Projects in the Field of Healthcare), No. 2024B1100; and Guangdong Provincial Administration of Traditional Chinese Medicine, No. 20241357.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, No. 2 Sunwen East Road, Zhongshan 528400, Guangdong Province, China. tian-ju@163.com
Received: May 9, 2025 Revised: May 27, 2025 Accepted: July 17, 2025 Published online: October 6, 2025 Processing time: 91 Days and 0.3 Hours
Abstract
BACKGROUND
Post-operative massive hemorrhage is a critical concern in oral cancer surgery, associated with severe complications and heightened morbidity and mortality rates.
CASE SUMMARY
A 46-year-old male with advanced poorly differentiated squamous cell carcinoma (ypT4aN3bN0M0) of the oral floor underwent extensive surgery, including total glossectomy, partial mandibulectomy, and free flap reconstruction. Postoperatively, he developed life-threatening hemorrhage on day 3 due to wound dehiscence. Rapid nursing interventions-prompt suture removal, pressure hemostasis, and multidisciplinary collaboration-controlled bleeding. Postoperative care emphasized hemodynamic monitoring, infection prevention, and rehabilitation. Despite comorbidities (hypertension, diabetes, prior stroke), the patient achieved functional recovery: Oral flap epithelialization, restored swallowing (water swallow test: Grade 1), 70% tongue mobility, and 80% preoperative chewing efficiency at 6-month follow-up. This case underscores the critical role of structured nursing protocols in managing postoperative hemorrhage and optimizing outcomes in high-risk oral cancer surgery.
CONCLUSION
This case report highlights the pivotal role of structured nursing interventions in managing life-threatening postoperative hemorrhage following complex oral cancer surgery. By integrating meticulous preoperative risk stratification, intraoperative hemostatic collaboration, and vigilant postoperative monitoring (e.g., timely suture management, pressure hemostasis, blood product administration), the interdisciplinary team achieved rapid hemorrhage control. Comprehensive psychological care and rehabilitation protocols further facilitated functional recovery, enabling the patient to regain swallowing, speech, and mobility despite advanced disease and comorbidities. The findings underscore that standardized nursing workflows, balancing procedural rigor with holistic patient support, are essential for mitigating complications and enhancing outcomes in high-risk head and neck surgical populations.
Core Tip: Postoperative massive hemorrhage in oral cancer surgery, driven by anatomical complexity and comorbidities, demands structured nursing interventions. Critical components include preoperative risk stratification, intraoperative hemostatic collaboration, and postoperative multimodal monitoring. Prompt suture removal, pressure hemostasis, and blood product support enabled rapid hemorrhage control. Integrated psychological care and rehabilitation ensured functional recovery. Standardized workflows are indispensable for optimizing outcomes in high-risk oral cancer surgeries.
