BACKGROUND: Despite widespread acceptance of enhanced recovery after surgery protocols in other surgical specialties, plastic surgery has been

 

Abstract

BACKGROUND:  Despite widespread acceptance of enhanced recovery after surgery protocols in other surgical specialties, plastic surgery has been slow to adopt fast-track principles. Recently, however, studies have shown that patients undergoing microsurgical breast reconstruction may benefit from a comprehensive postoperative protocol.

METHODS:  All microsurgical breast reconstructions with abdominal free flaps performed by the senior author (A.K.) at a single institution from June 2009 to December 2013 were reviewed. Demographic information (e.g., age, body mass index, and comorbidities), operative details (e.g., laterality, type of flap), and postoperative data (e.g., complications, length of stay) were collected from patients' medical records. The authors employed a universal comprehensive protocol that dictated all postoperative care as it relates to diet, ambulation, flap monitoring, anticoagulation, analgesia, venous thromboembolism, antibiotic prophylaxis, and discharge criteria.

RESULTS:  During the study period, 161 patients underwent 289 free flaps. The average length of stay for all patients was 3.26 ± 1.19 days. The incidence of complications requiring return to the operating room was 4.35% (7 patients). The incidence of flap failure was 0.69% (2 of 289 flaps). Only one flap failure occurred after hospital discharge. Statistical analysis demonstrated that the presence of any complication requiring return to the operating room increased hospital course by an average of 1.37 days (p = 0.0027).

CONCLUSION:  The standardization of postoperative care for patients undergoing microsurgical breast reconstruction results in a short hospital length of stay without increasing the incidence of flap failure or postoperative complications requiring return to the operating room.

PMID: 31042802 [PubMed - indexed for MEDLINE]

14:58

Cancer & Heart (Cardio-Oncology, Cardiotoxicity, TEV)

Photo

Not included, change data exporting settings to download.

256×256, 6.0 KB

14:58

In reply to this message

pubmed: ctoall&ca or conall

Case of pembrolizumab-induced myocarditis presenting as torsades de pointes with safe re-challenge.

Related Articles

Case of pembrolizumab-induced myocarditis presenting as torsades de pointes with safe re-challenge.

J Oncol Pharm Pract. 2020 Feb 23;:1078155220904152

Authors: Lee DH, Armanious M, Huang J, Jeong D, Druta M, Fradley MG

PMID: 32089073 [PubMed - as supplied by publisher]

26 February 2020

12:43

Cancer & Heart (Cardio-Oncology, Cardiotoxicity, TEV)

Photo

Not included, change data exporting settings to download.

256×256, 6.0 KB

12:43

In reply to this message

pubmed: ctoall&ca or conall

Stearoyl-CoA desaturase-1 impairs the reparative properties of macrophages and microglia in the brain.

Stearoyl-CoA desaturase-1 impairs the reparative properties of macrophages and microglia in the brain.

J Exp Med. 2020 May 04;217(5):

Authors: Bogie JFJ, Grajchen E, Wouters E, Corrales AG, Dierckx T, Vanherle S, Mailleux J, Gervois P, Wolfs E, Dehairs J, Van Broeckhoven J, Bowman AP, Lambrichts I, Gustafsson JÅ, Remaley AT, Mulder M, Swinnen JV, Haidar M, Ellis SR, Ntambi JM, Zelcer N, Hendriks JJA