An Update on the Safety and Efficacy of Outpatient Plastic Surgery: A Review of 26,032 Consecutive Cases

Rohrich, Rod J.; Mendez, Bernardino M.; Afrooz, Paul N.

doi:10.1097/prs.0000000000004213

Cited by 24 publications

(26 citation statements)

References 21 publications

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“… 8 – 10 Outpatient procedures inherently cost less and result in significant savings and decreased utilization of hospital beds. 11 Surgeries can be moved to ambulatory surgery centers (ASCs), which have documented benefits with regard to efficiency, cost, patient and surgeon satisfaction, scheduling flexibility, and possibly reduced complications compared with the hospital setting (HS). 12 – 14 These are critical factors in a healthcare system which is becoming increasingly less efficient and cost-effective.…”

Section: Introductionmentioning

confidence: 99%

Mastectomy and Prepectoral Reconstruction in an Ambulatory Surgery Center Reduces Major Infectious Complication Rates

Schwartz

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Mastectomy and implant-based reconstruction is typically performed in a hospital setting (HS) with overnight admission. The aim of this study was to evaluate postoperative complications and outcomes with same-day discharge from an ambulatory surgery center (ASC) compared with the same surgery performed in the HS. Methods: Patients who underwent mastectomy and immediate prepectoral tissue expander reconstruction were included in this retrospective study. Surgery was performed in an ASC with same-day discharge or the HS with overnight observation or same-day discharge. Patient demographics, operative details, outcomes, complications, and patient satisfaction were compared. Results: One hundred six women (183 breasts) underwent surgery in the HS, and 103 women (177 breasts) had their surgery in an ASC between August 2014 and September 2019. Demographics, comorbidities, and operative details were similar. Although there was no difference in the rates of most major complications, infectious complications requiring operative intervention were less frequent in the ASC [2.3% (n = 4) versus 11.5% (n = 21); P = 0.001]. Patient satisfaction, evaluated with a 5-point Likert scale, was higher in the ASC. Conclusions: Mastectomy and prepectoral reconstruction in an ASC is a safe alternative to the standard approach of performing this procedure in the HS. Although the rates of most surgical complications are similar between the HS and ASC, we have found a significantly reduced rate of major infectious complications requiring surgical intervention in the ASC which reduces overall cost and patient morbidity. Finally, patient satisfaction was higher in the ASC compared with the HS.

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Section: Introductionmentioning

confidence: 99%

Mastectomy and Prepectoral Reconstruction in an Ambulatory Surgery Center Reduces Major Infectious Complication Rates

Schwartz

2020

Plastic and Reconstructive Surgery - Global Open

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“…Rohrich et al 6 showed how outpatient surgery offers many advantages, including cost-containment, privacy, and convenience, even though patient safety should be prioritized over these benefits. It should be noted that limited well-designed studies exist in the scientific literature on patient safety in the outpatient setting especially regarding reconstruction with skin flaps, which is generally performed only in the operating theater.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Nonmelanoma Skin Cancer Excision and Reconstruction: A Clinical, Economical, and Patient Perception Analysis

Lisa

Vinci

Galtelli

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Nonmelanoma skin cancers constitute more than 15% of all types of cancer. To obtain the best cosmetic outcome, local flaps represent the ideal surgical choice. Methods: We conducted a retrospective review of patients treated from 2016 to 2019. The day-surgery group included 73 patients, and the outpatient group included 70 patients. We analyzed medical records regarding age of diagnosis, waiting time, site of lesion, reconstructive technique, histologic diagnosis, radicality of excision, and complications. We administered a survey based on quality items and carried out an economic evaluation. Results: Outpatient removals were radical 92.6% of the time against the 78% of those performed in the operating room ( P = 0.14). We observed two cases of wound dehiscence and two cases of hematoma in the day-surgery group. Economic analysis showed reduced costs in the outpatient setting. Conclusion: Skin excision and local flap reconstruction are safe procedures in an outpatient setting under a clinical, economical, and patient perception point of view.

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“…En general las cirugías combinadas se asocian a un mayor tiempo operatorio, sangrado y trauma quirúrgico, lo que explica el mayor número de complicaciones al asociar varios procedimientos en un solo acto quirúrgico. (18) Harton y col. (4) reportan una mortalidad asociada a liposucción como procedimiento único en el 0.0021% de los pacientes (1 por cada 47.415 cirugías), pero la mortalidad se incrementa significativamente cuando se tienen en cuenta cirugías múltiples. Según estos autores, al combinarla con procedimientos diferentes a abdominoplastia la mortalidad se incrementa al 0.0305% (1 por cada 7314 pacientes).…”

Section: Discussionunclassified

“…Cuando las pérdidas sanguíneas exceden los 500 ml o la duración de la cirugía es superior a 2 horas, la morbilidad y la mortalidad se incrementan significativamente. (18) Según nuestros hallazgos, el promedio del tiempo quirúrgico de los pacientes que se complicaron fue de 200 minutos (percentil 25 de 113 minutos); es decir, las cirugías cortas, inferiores a 2 horas, presentaron pocas complicaciones y por lo tanto, mínimas posibilidades de requerir recursos hospitalarios. A pesar de que las liposucciones con estas características no están exentas de complicaciones, los datos recolectados soportan que de este modo sería posible disminuir significativamente el número de pacientes con complicaciones severas y la necesidad de recursos hospitalarios adicionales.…”

Section: Discussionunclassified

Requerimiento de servicios hospitalarios en Cirugía Estética ambulatoria: análisis de complicaciones en 13.411 casos consecutivos e implicaciones para la práctica en el contexto de la pandemia COVID-19

Gómez

Lara

Ríos

2021

Cir. plást. iberolatinoam.

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Conflicto de intereses: Los autores declaran no tener ningún interés financiero relacionado con el contenido de este artículo. Financiación: No hubo fuentes externas de financiación para este trabajo. CIRUGÍA PLÁSTICA IBERO-LATINOAMERICANA Original / Series clínicas ESTÉTICA Palabras clave COVID-19, Complicaciones posoperatorias, Cirugía Plástica, Cirugía Estética, Cirugía ambulatoria. Nivel de evidencia científica 4c Terapéutico Recibido (esta versión) 20 julio / 2020 Aceptado 16 mayo / 2021

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An Update on the Safety and Efficacy of Outpatient Plastic Surgery: A Review of 26,032 Consecutive Cases

Abstract: Risk, III.

Cited by 24 publications

References 21 publications

Mastectomy and Prepectoral Reconstruction in an Ambulatory Surgery Center Reduces Major Infectious Complication Rates

Mastectomy and Prepectoral Reconstruction in an Ambulatory Surgery Center Reduces Major Infectious Complication Rates

Outpatient Nonmelanoma Skin Cancer Excision and Reconstruction: A Clinical, Economical, and Patient Perception Analysis

Requerimiento de servicios hospitalarios en Cirugía Estética ambulatoria: análisis de complicaciones en 13.411 casos consecutivos e implicaciones para la práctica en el contexto de la pandemia COVID-19

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