Resuming autologous free tissue transfer for breast reconstruction in the COVID-19 era

Masud, Dhalia; Sharp, Olivia; Rosich-Medina, Anais; Köhler, Guido; Haywood, Richard M.

doi:10.1016/j.bjps.2020.08.079

Cited by 8 publications

(23 citation statements)

References 1 publication

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“… 6 , 13 , 14 , 17 , 18 , 21 – 23 , 26 , 27 Many authors cautioned the dangers of overlooking ABR and relying too heavily on implant-based breast reconstruction, and three studies described the successful resumption of ABR and established its safety during the COVID-19 pandemic. 4 , 15 , 24 , 25 One commentary described successful ABR in an asymptomatic carrier of COVID-19 in March 2020, the early stage of the pandemic before COVID-19 guidelines had been established. 29 …”

Section: Resultsmentioning

confidence: 99%

“…Nearly all studies offered guidance on how to perform breast reconstruction during the pandemic; however, only 10 studies discussed the development of specific protocols. 14 , 16 , 18 , 20 , 24 , 26 , 27 , 30 , 34 , 35 …”

Section: Resultsmentioning

confidence: 99%

“…These protocols involved assessment of patient variables such as age, breast cancer characteristics, need for adjuvant therapy, and other comorbidities. 16 , 18 , 24 , 27 , 30 , 34 …”

Section: Resultsmentioning

confidence: 99%

“…Multidisciplinary teams involving breast surgeons, plastic surgeons, anesthesiologists, nurses, hospital administrators, and legal representatives were employed when devising these protocols to ensure appropriate allocation of limited resources in a manner that optimized safety for both the patient and the healthcare team. 16 , 18 , 24 , 27 , 30 , 34 Two groups shared their protocols for performing ABR during the pandemic. In both cases, these focused on streamlining preoperative workup while balancing limited contact between patient and the healthcare team.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Breast Reconstruction during the COVID-19 Pandemic: A Systematic Review

Hemal

Boyd

Bekisz

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Introduction:The COVID-19 pandemic posed unique challenges for breast reconstruction. Many professional organizations initially placed restrictions on breast reconstruction, leading surgeons to conceive innovative protocols for offering breast reconstruction. This study reviewed the current evidence on breast reconstruction during the COVID-19 pandemic to provide guidance for surgeons facing future crises. Methods: The MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews were searched for studies (1) describing implant and autologous breast reconstruction following mastectomy and (2) occurring during or pertaining to the COVID-19 pandemic. Results: Of the 1347 studies identified, 26 were included. Studies discussed type of reconstruction (18, 69%), complications (11, 42%), timing of reconstruction (10, 38%), protocols (10, 38%), COVID-19 screening (7, 27%), and length of hospital stay (7, 27%). The type of reconstruction varied depending on the stage of the pandemic: early on, autologous breast reconstruction was halted to preserve resources, but was later resumed. Within implant-based reconstruction, direct-toimplant was favored over serial tissue expansion. Several protocols were developed, with many emphasizing multidisciplinary collaborations for patient selection, use of specialized measures to reduce risk of COVID-19 transmission, and optimization of same-day discharge. Complication rates following breast reconstruction were similar to pre-pandemic rates. Conclusions: The COVID-19 pandemic has forever changed the landscape of breast reconstruction by raising important questions about delivery of care, cost, and resource utilization. The findings of this review may inform surgeons as they plan for similar future crises or strive for improved patient care and efficacy even during nonpandemic times.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…These protocols involved assessment of patient variables such as age, breast cancer characteristics, need for adjuvant therapy, and other comorbidities. 16 , 18 , 24 , 27 , 30 , 34 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Breast Reconstruction during the COVID-19 Pandemic: A Systematic Review

Hemal

Boyd

Bekisz

et al. 2021

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…We read with interest the article by Masud et al in August 2020. 1 The authors layout the problems faced due to the cessation of elective breast reconstruction surgery as a result of the initial phase of the COVID-19 response, and their algorithm for recommencing their service. Our service noted as the recovery restitution phase from the coronavirus pandemic continues, a particular challenge is faced by breast reconstruction teams.…”

Section: Restitution Of the Nhs Breast Reconstruction Service During mentioning

confidence: 99%

Restitution of the NHS breast reconstruction service during the recovery phase of the Covid 19 pandemic

Vigneswaran

Clancy

Jackson

et al. 2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Effects of COVID‐19 on mastectomy and breast reconstruction rates: A national surgical sample

Rubenstein

Stern

Plotsker

et al. 2022

Journal of Surgical Oncology

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Background The COVID‐19 pandemic profoundly impacted breast cancer treatment in 2020. Guidelines initially halted elective procedures, subsequently encouraging less invasive surgeries and restricting breast reconstruction options. We examined the effects of COVID‐19 on oncologic breast surgery and reconstruction rates during the first year of the pandemic. Methods Using the National Surgical Quality Improvement Program, we performed an observational examination of female surgical breast cancer patients from 2017 to 2020. We analyzed annual rates of lumpectomy, mastectomy (unilateral/contralateral prophylactic/bilateral prophylactic), and breast reconstruction (alloplastic/autologous) and compared 2019 and 2020 reconstruction cohorts to evaluate the effect of COVID‐19. Results From 2017 to 2020, 175 949 patients underwent lumpectomy or mastectomy with or without reconstruction. From 2019 to 2020, patient volume declined by 10.7%, unilateral mastectomy rates increased (70.5% to 71.9%, p = 0.003), and contralateral prophylactic mastectomy rates decreased. While overall reconstruction rates were unchanged, tissue expander reconstruction increased (64.0% to 68.4%, p < 0.001) and direct‐to‐implant and autologous reconstruction decreased. Outpatient alloplastic reconstruction increased (65.7% to 73.8%, p < 0.0001), and length of hospital stay decreased for all reconstruction patients ( p < 0.0001). Conclusions In 2020, there was a nearly 11% decline in breast cancer surgeries, comparable mastectomy and reconstruction rates, increased use of outpatient alloplastic reconstruction, and significantly reduced in‐hospital time across all reconstruction types.

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Resuming autologous free tissue transfer for breast reconstruction in the COVID-19 era

Cited by 8 publications

References 1 publication

Breast Reconstruction during the COVID-19 Pandemic: A Systematic Review

Breast Reconstruction during the COVID-19 Pandemic: A Systematic Review

Restitution of the NHS breast reconstruction service during the recovery phase of the Covid 19 pandemic

Effects of COVID‐19 on mastectomy and breast reconstruction rates: A national surgical sample

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