The League of Friends fully supported a bid from the Oral and Maxillofacial Unit and the nursing staff on Laverstock to purchase a Hilotherm unit to be used on patients undergoing corrective jaw surgery at Salisbury District Hospital.
The Hilotherm Device, manufactured in Germany, circulates cool fluid through a variety of masks and formas that have been developed to be applied to different areas of the body to help reduce swelling. After jaw surgery, whilst in the recovery area, a facial mask, similar to a face pack, is placed on the face before post-operative swelling has developed. Two small tubes attach the mask to the Hilotherm unit, which is similar in size to a domestic toaster. The unit pumps water at a constant 17°C through the mask, keeping the face cool. The cooling effect is not only soothing, but reduces the post-operative swelling. These patients are in theatre for 3-4 hours and their faces can be very swollen afterwards. This in turn can make the face very painful and swallowing difficult.
The Hilotherm has been used on 36 patients to date with a very positive effect for both patients and staff. It is easy to apply and use and we estimate that it saves about 45mins of nursing time over every 24 hours as the nurses are no longer having to replace ice cubes in a rather 'Heath Robinson' arrangement of surgical gloves filled with ice applied to the face with tubigrip. Staff noted a significant improvement in the quality of the patients' post-operative wellbeing, with a marked reduction in the post-operative swelling, bruising, bleeding and pain. There was also a reduction in the amount of analgesia required by the patients. As the majority of our patients who undergo osteotomies are teenagers, the reduction in swelling and pain improves their self-esteem and recovery. The nursing and medical staff also noted a significant improvement in the patient experience in those who had had the benefit of the Hilotherm Device.
Two patients have kindly provided feedback of their experience with the Hilotherm. Lisa underwent single jaw surgery shortly after we took delivery of the Hilotherm;
“I have been a Dental Nurse in the Oral & Maxillofacial Surgery unit for 5 years, working closely with patients undergoing corrective jaw surgery. Having seen numerous patients have these operations, I noticed that they had significant swelling post-operatively which could only be reduced by using ice-packs. I had my surgery nearly a year ago, fortunately after the introduction of the Hilotherm machine. I found it to be cool and soothing and it made me feel more comfortable during the post-operative phase. The swelling I had was much reduced in comparison to patients whom I had seen and who did not have the opportunity to use a Hilotherm. Since our patients have been using the Hilotherm, I have noticed significant improvement in post-operative swelling and patients have commented on the reduction in discomfort following their operation and would recommend it to fellow patients.”
Robert had surgery on both jaws;
“I had double jaw surgery in October 2017 performed by Mr Downie and Mr Kunjur at Salisbury District Hospital. I was placed in a Hilotherm mask immediately after surgery and wore it for the remainder of my stay in hospital. The mask was invaluable in keeping me comfortable in the 24 hours following my surgery. It was extremely effective in cooling my face and neck, reducing pain and swelling. This allowed me to rest as best as possible and this, I believe, contributed significantly to my quick and successful recovery. I would recommend its use to any patient having double jaw surgery.”
Two patients can be connected to the Hilotherm at any one time. Initially, we were able to take full advantage of this by ensuring that, if we performed two cases on the same day and the patients were the same sex, they could be nursed in beds next to each other and both would benefit from the Hilotherm. Unfortunately, with the ward reconfiguration, there was a period of about two months when it was not possible to nurse two patients undergoing jaw surgery next to each other. As a consequence, there were four patients that were not able to have the use of the Hilotherm. There was a very dramatic difference in the amount of swelling and this further highlighted the benefits of the Hilotherm. There has since been further reorganisation enabling two patients to be nursed next to each other.
We are extremely grateful to the League of Friends for providing funding for the Hilotherm, which has undoubtedly improved the post-operative experience for patients, made life easier for the nursing staff and freed up valuable time for the nurses.
Ian Downie – Consultant Oral & Maxillofacial Surgeon