Increased Time Interval of Postoperative Flap Monitoring After Autologous Breast Reconstruction.

Autor:	Schwartzberg HG; From the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA., Doran HE; LSUHSC School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA., Bartow MJ; From the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA., Patterson C; University of Vermont Larner College of Medicine, Burlington, VT., Stalder MW, Allen RJ Sr; From the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA., St Hilaire H; From the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
Jazyk:	angličtina
Zdroj:	Annals of plastic surgery [Ann Plast Surg] 2024 Jun 01; Vol. 92 (6S Suppl 4), pp. S413-S418.
DOI:	10.1097/SAP.0000000000003977
Abstrakt:	Background: Hourly flap checks are the most common means of flap monitoring during the first 24 hours following autologous breast reconstruction (ABR). This practice often requires intensive care unit (ICU) admission, which is a key driver of health care costs and decreased patient satisfaction. This study addresses these issues by demonstrating decreased cost and length of admission associated with a 4-hour interval between flap checks during the first 24 hours following ABR. Methods: This is a retrospective review of ABR surgeries performed by multiple surgeons from 2017 to 2020. Two cohorts were identified, one that underwent flap checks every hour in the ICU (Q1 cohort) and the other that underwent flap checks every 4 hours on the hospital floor (Q4 cohort). Our primary outcome measures were length of stay (LOS), flap takebacks, flap loss, and encounter cost. Results: Rates of flap takeback and loss did not differ between cohorts (P = 0.18, P = 0.21). The Q4 cohort's average LOS was shorter than the Q1 cohort (P = 0.002). The Q4 cohort's average cost was also $25,554.80 less than the Q1 cohort (P < 0.001). This association persisted after controlling for LOS, operating room takeback, timing and laterality of reconstruction, and flap configuration (hazard ratio = 0.65, P = 0.0007). Conclusion: This study demonstrates the benefits of lengthened flap check intervals during the first 24 hours following ABR. These intervals decrease the cost of ABR while also maintaining safety, making ABR a more accessible option for breast reconstruction patients. Competing Interests: Conflicts of interest and sources of funding: none declared. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu