🇬🇧 Enhanced Recovery After Orthognathic Surgery (ERAS-Ortho): A Comprehensive Patient Guide
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🧠 Part I – Understanding ERAS: Concept and Background
The ERAS (Enhanced Recovery After Surgery) protocol is a multidisciplinary, evidence-based approach first introduced in the 1990s by Danish surgeon Henrik Kehlet.
Its main goal is to reduce the body’s physiological stress response to surgery and help patients recover faster and return to normal activity sooner.
Traditionally, surgical recovery involved prolonged bed rest, fasting, and delayed mobility, which often led to complications such as weakened immunity and slower wound healing.
Kehlet’s research revealed that this conventional approach was counterproductive — hence, ERAS was designed to optimize recovery through coordinated efforts among surgeons, anesthesiologists, nutritionists, and nursing teams.
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🔬 Part II – Importance of ERAS in Orthognathic (Jaw) Surgery
Orthognathic surgery, performed to correct jaw deformities and malocclusions, involves several challenges: pain, swelling, nutritional difficulties, and anxiety — all of which can delay recovery.
Recent application of ERAS principles in jaw surgery has shown remarkable improvements:
Clinical Indicator Before ERAS After ERAS
Hospital stay 5–7 days 2–3 days
Postoperative pain Moderate to severe Mild and controlled
Oral feeding start 2–3 days post-op 4–6 hours post-op
Return to normal activity ~2 weeks <7 days
Common complications (edema, nausea, infection) 20–30% <10%
Studies such as Beedkar et al. (2025) and Betti et al. (2025) have confirmed that implementing ERAS in maxillofacial surgery results in:
•Reduced opioid use,
•Accelerated bone and soft tissue healing,
•Higher patient satisfaction.
Today, ERAS-Ortho is recognized as a standard of care in many advanced maxillofacial centers worldwide.
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💬 Part III – Patient Guide for Implementing ERAS Principles
Below is a practical step-by-step guide to help you actively participate in your recovery and achieve optimal outcomes.
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🔹 Phase 1 – Before Surgery
1.Education and Calmness
•Learn about your surgery and recovery process from your healthcare team.
•It’s normal to feel anxious — knowledge brings comfort and confidence.
2.Preoperative Nutrition
•Eat a balanced, high-protein, nutrient-rich diet for at least two weeks before surgery.
•Light carbohydrate drinks are allowed up to 2 hours before anesthesia.
•Avoid smoking and alcohol at least two weeks prior to surgery.
3.Physical Preparation
•Maintain excellent oral hygiene (brushing, flossing, mouthwash) the night before.
•Take your regular medications as prescribed unless advised otherwise.
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🔹 Phase 2 – Day of Surgery
•Arrive fasting in the morning but drink a small amount of water if permitted.
•Mild facial swelling or heaviness after anesthesia is normal.
•Begin deep breathing exercises early to prevent secretion buildup and improve lung function.
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🔹 Phase 3 – After Surgery
1.Pain and Swelling Control
•Take prescribed painkillers exactly as directed.
•Apply cold compresses for the first 48 hours to reduce swelling.
•Do not apply ice directly — use a clean cloth barrier.
2.Proper Nutrition
•Start with clear, cool liquids 4–6 hours post-surgery.
•Transition to smooth, soft foods (porridge, blended soups) the next day.
•Avoid using a straw to prevent negative pressure in the mouth.
3.Oral Hygiene
•Rinse twice daily with chlorhexidine mouthwash from day two onward.
•Use a soft toothbrush for accessible areas.
4.Mobility and Sleep
•Begin gentle walking the day after surgery.
•Sleep with your head elevated to reduce facial swelling.
5.Follow-Up Care
•First postoperative visit: 5–7 days after surgery.
•Contact your surgeon immediately if you experience fever, unusual bleeding, or pain.
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🌸 Golden Tips for Faster Recovery
✅ Eat high-protein, nutrient-dense foods.
✅ Prioritize adequate rest and mental calmness.
✅ Avoid smoking — nicotine severely delays bone healing.
✅ Refrain from heavy lifting or sudden head movements.
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💪 Conclusion
The ERAS-Ortho protocol represents a scientific and human partnership between the patient and the surgical team.
When applied correctly, it shortens recovery time, reduces pain and swelling, and improves emotional well-being.
Fast recovery is not a coincidence — it’s the result of knowledge, cooperation, and mutual trust between you and your healthcare team.
