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Do Microsurgical Outcomes Differ Based on Which Specialty Does the Operation? A NSQIP Analysis.

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Plastic and Reconstructive Surgery. Global Open
|May 23, 2020
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Summary

Surgical specialty does not impact microsurgical complication rates like surgical site infection (SSI) or reoperation. However, lower case volumes correlate with higher complications, emphasizing the need for surgeons to maintain broad experience.

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Area of Science:

  • Microsurgery
  • Surgical Outcomes
  • Health Services Research

Background:

  • Plastic surgery faces encroachment from other specialties for historically performed procedures.
  • Decreased case volume is linked to increased complication rates.
  • Investigating the impact of volume and specialty on microsurgical complications is crucial.

Purpose of the Study:

  • To determine if surgical specialty influences microsurgical complication rates.
  • To assess the relationship between case volume and complications.
  • To analyze surgical site infection (SSI) and reoperation rates in microsurgery.

Main Methods:

  • Utilized the 2005-2015 National Surgical Quality Improvement Program data.
  • Analyzed Current Procedural Terminology codes for breast and head/neck microsurgeries.
  • Employed multivariate logistic regression and cumulative frequency analysis.

Main Results:

  • No significant difference in SSI or reoperation rates was found between plastic surgery and other specialties.
  • Lower rates of SSI were observed in plastic surgery for head/neck and breast reconstructions, but not significantly.
  • Increased case volume demonstrated a negative correlation with complication rates.

Conclusions:

  • Surgical specialty does not appear to affect SSI and reoperation rates in microsurgery.
  • Lower surgical volumes are associated with increased complications.
  • Maintaining broad case experience and volume is vital for optimizing outcomes and preserving surgical skills.