The impact of resident involvement in breast reconstruction surgery outcomes by modality: An analysis of 4,500 cases
| Autor: | Aldona J. Spiegel, Kevin T. Jubbal, Anthony Echo, Shayan A. Izaddoost |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Graft Rejection Operating Rooms medicine.medical_specialty Breast Implants Mammaplasty Operative Time Rectus Abdominis Free flap 030230 surgery Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Reference Values Risk Factors Outcome Assessment Health Care medicine Humans Surgical Wound Infection Major complication Aged Retrospective Studies Patient Care Team Analysis of Variance business.industry Graft Survival Internship and Residency Retrospective cohort study Length of Stay Middle Aged Myocutaneous Flap Acs nsqip Surgery Education Medical Graduate 030220 oncology & carcinogenesis Multivariate Analysis Surgery outcome Superficial Back Muscles Female Implant Breast reconstruction business Cohort study |
| Zdroj: | Microsurgery. 37:800-807 |
| ISSN: | 0738-1085 |
| Popis: | Background The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. Methods We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities. Primary outcomes measured include major and wound complications. Results A total of 4,500 cases were included in this analysis, of which residents participated in 1,743 (38.7%). Major complications occurred in 7.2% of all cases, and wound complications occurred in 3.3% of all cases. BMI was positively correlated with major complications in free flap, implant, and TRAM reconstruction groups. Wound complications were associated with BMI in free flap, implant, and TRAM reconstruction, with steroid use in implant and TRAM reconstruction, and with a history of bleeding disorder in LD reconstruction. Resident involvement did not reach significance in any reconstruction group as an independent factor for major or wound complications. Conclusions Resident involvement is safe and effective across implant, free flap, LD, and TRAM based methods of breast reconstruction with similar major and wound complication rates. Participation of trainees in these surgical cases is imperative for future patient care. |
| Databáze: | OpenAIRE |
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