Postoperative Day 1 Discharge in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery

Background:

• Autologous breast reconstruction success rates are high, shifting focus to patient outcomes.
• Historically, prolonged hospital stays have been a drawback of autologous breast reconstruction.
• Early hospital discharge is increasingly explored to improve patient experience.

Purpose of the Study:

• To evaluate the safety and feasibility of discharging patients on postoperative day 1 (POD1) after DIEP flap breast reconstruction.
• To identify preoperative and intraoperative factors associated with successful POD1 discharge.

Main Methods:

• Retrospective chart review of 510 patients undergoing 846 DIEP flap breast reconstructions (January 2019 - March 2022).
• Data collected included patient demographics, medical history, operative details, and postoperative outcomes.
• Comparison between patients discharged on POD1 and those discharged later (POD2+).

Main Results:

• Twenty-three patients (33 flaps) were discharged on POD1.
• No significant differences in age, ASA score, or comorbidities between POD1 and POD2+ groups.
• POD1 group had significantly lower BMI and shorter operative times (unilateral and bilateral).
• No major complications were observed in the POD1 discharge group.

Conclusions:

• Same-day discharge (POD1) is a safe option for select patients undergoing DIEP flap breast reconstruction.
• Lower body mass index (BMI) and reduced operative time are potential predictors for early discharge eligibility.
• Optimizing discharge criteria can enhance patient recovery and hospital resource utilization.