A structured pathway for accelerated postoperative recovery reduces hospital stay and cost of care following microvascular breast reconstruction without increased complications

Nipple‐sparing mastectomy with immediate breast reconstruction with a deep inferior epigastric perforator flap without skin paddle using delayed primary retention suture

“…It showed less distortion of the breast in Group B ( p = 0.04), VAS, and overall significantly better scarring in patients without a skin paddle of Group B ( p = 0.03 and 0.04). The average LOS in the study was 10.5 days (range: 8–15 days), which is longer than the reported literature of LOS from 3.6 to 5.5 days 35,36 . Our current protocol can explain this increase in LOS.…”

“…The average LOS in the study was 10.5 days (range: 8-15 days), which is longer than the reported literature of LOS from 3.6 to 5.5 days. 35,36 Our current protocol can explain this increase in where patients wish to be discharged having recovered fully from their procedure. However, we are working to reduce the mean LOS for these patients by adjusting our postoperative management protocol.…”

Setting up a new microsurgical breast service in a non-tertiary hospital: Is it safe, and do outcomes compare to centres of excellence?

“…A key aim of enhanced recovery protocols (ERAS) is reducing the length of hospital stay. Recent publications of enhanced recovery protocols from well-established large volume centres have demonstrated a median length of stay between 4-7 days [4][5][6][7][8][9][10][11]26 .…”

“…Many units see autologous reconstruction as a complex procedure that is best performed at a high volume centres with a long-established history of microsurgery and excellent outcomes [4][5][6][7][8][9][10][11][12] . The problem with this approach is that patients can be denied this form of reconstruction due to a geographical availability, especially when the surgery is time critical, or be required to travel significant distances, often with complete transfer of their care, to a centre that offers it 13 .…”

Comment on: “A structured pathway for accelerated postoperative recovery reduces hospital stay and cost of care following microvascular breast reconstruction without increased complications”

“…We read with great interest a recent article by O'Neill et al 1 on the implementation of an accelerated postoperative recovery protocol following DIEP flap breast reconstruction. Our department has formally introduced a DIEP Enhanced Recovery After Surgery (ERAS) Pathway in May 2019.…”