SUSTENANCE: Development of a toolkit to improve post-operative feeding practices and nutritional intake in patients with head and Neck cancer undergoing surgery with flap tissue transfer reconstruction

This study aims to improve nutrition for head and neck cancer patients transitioning from tube-feeding to eating after surgery. In the UK, 12,400 people are diagnosed with this cancer annually, with 75% undergoing surgery, often requiring reconstruction (‘flap’ surgery). Post-surgery, patients receive nutrition via a feeding tube, but the timing of restarting oral intake and tube removal varies due to swallowing ability, swelling, and hospital policies. Nasal tubes are often removed early, even before patients can eat enough, as they may delay discharge. Research shows 40–72% of patients struggle to meet nutritional needs post-surgery, impacting recovery, wound healing, survival, and well-being. This study will identify factors affecting resumption optimal oral intake to ensure feeding tubes are removed at the right time. We will review existing research, survey UK healthcare professionals, analyse hospital data, and observe staff practices and patient experiences. Findings will inform a staff toolkit to improve feeding practices. Patients who have undergone flap surgery shared that they lacked confidence when restarting eating, often facing abrupt transitions, which made them feel isolated. They will help shape this study by reviewing study materials. Results will be shared through social media, blogs, an animated video, charities, and professional meetings to enhance practice and patient support.