One-stop autologous breast reconstruction: A safe and effective cost-saving pathway.

Autor: Mughal M; Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom. Electronic address: maleeha.mughal@gstt.nhs.uk., Berner JE; Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom., Ho-Asjoe M; Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom., See M; Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom., Roblin P; Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom., Rose V; Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom., Mohanna PN; Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, United Kingdom.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2024 May; Vol. 92, pp. 276-281. Date of Electronic Publication: 2023 May 27.
DOI: 10.1016/j.bjps.2023.05.048
Abstrakt: Introduction: Patients undergoing autologous breast reconstruction usually require further operations as part of their reconstructive journey. This involves contralateral breast symmetrization and nipple-areola complex (NAC) reconstruction. Restrained access to elective operating space led us to implement a one-stop breast reconstruction pathway.
Methods: Patients undergoing contemporaneous contralateral breast symmetrization and immediate NAC reconstruction with free nipple grafts between July 2020 and June 2021 were identified. A retrospective review of our prospectively maintained database was conducted, to retrieve surgical notes, postoperative complications, and length of inpatient stay. A cost analysis was performed considering savings from contralateral symmetrization.
Results: A total of 50 eligible cases were identified, which had unilateral one-stop breast reconstructions. Complication rates and length of stay were not affected by this approach, with only one free flap being lost for this cohort. This approach resulted in £181,000 being saved for our service over a calendar year.
Discussion: A one-stop breast reconstruction pathway has proven to be safe and effective in our unit. During these uncertain times, it has streamlined the management of eligible patients, while releasing capacity for other elective operations. Patients avoid having to wait for secondary procedures, finishing their reconstructive pathway earlier. We plan to continue providing this service which has shown to be beneficial clinically and financially.
Competing Interests: Declaration of Competing Interest The authors do not have any conflicts of interest to disclose.
(Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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