ENHANCED RECOVERY PROTOCOL FOLLOWING AUTOLOGOUS FREE TISSUE BREAST RECONSTRUCTION

Area of Science:

• Plastic Surgery
• Surgical Outcomes
• Patient Recovery

Background:

• Enhanced Recovery After Surgery (ERAS) protocols aim to optimize patient recovery.
• ERAS protocols focus on reducing hospital length of stay (LOS) and improving surgical outcomes.
• Evaluating ERAS protocol effectiveness is crucial for refining patient care.

Purpose of the Study:

• To review the experience with an ERAS protocol for autologous breast reconstruction.
• To evaluate LOS, post-operative complications, discharge analgesia, and patient satisfaction.
• To compare the protocol's outcomes with existing literature.

Main Methods:

• Retrospective review of a prospectively managed database (January 2016 - December 2016).
• Collected data included patient demographics, LOS, discharge analgesia, and complications.
• Patient satisfaction assessed via a 10-point Likert scale questionnaire.

Main Results:

• 70 patients underwent free deep inferior epigastric artery (DIEP) flap breast reconstruction.
• Mean LOS was 4.89 days, with 87% discharged within 5 days.
• 93% were discharged without controlled opioids; major/minor complications occurred in 4% and 7% respectively. Patient satisfaction was high (>9/10), with complaints of nausea/vomiting.

Conclusions:

• The ERAS protocol for autologous breast reconstruction achieved LOS and opioid use reduction comparable to literature.
• Further refinements to the ERAS protocol are needed.
• Developing a stronger evidence base and continuous audit cycles are essential for optimizing patient outcomes.