Free Tissue Transfer during the COVID-19 Pandemic: A Proposed Evidence-Based Protocol for Early Discharge

Area of Science:

• Plastic Surgery
• Surgical Outcomes
• Healthcare Management

Background:

• Improving outcomes in free tissue transfer (FTT) prompt examination of early discharge protocols (1-5 days postoperatively).
• Early discharge aligns with the period of highest risk for complications and flap salvage opportunities.
• Healthcare cost reduction and ICU bed shortages, particularly during pandemics, necessitate efficient patient management.

Purpose of the Study:

• To propose an evidence-based protocol for selecting patients for discharge within 72 hours after FTT.
• To identify factors contributing to successful early postoperative discharge in FTT patients.

Main Methods:

• Retrospective review of FTT patients discharged within 72 hours during the COVID-19 pandemic (2020-2021) at Vanderbilt University Medical Center.
• Inclusion criteria focused on patients discharged within 72 hours post-surgery.
• Literature review on expedited discharge protocols for FTT.

Main Results:

• Six patients met the inclusion criteria for retrospective review.
• No intraoperative or postoperative inpatient complications were observed in these patients.
• All patients were discharged within 72 hours with no flap failures within 30 days.

Conclusions:

• FTT patients can be safely discharged within 72 hours, as demonstrated by a cohort during the COVID-19 pandemic.
• Early discharge protocols can reduce healthcare costs, inpatient risks, and ICU utilization.
• This study provides data to support the development of a protocol for selecting appropriate FTT patients for early discharge.