Variation in the perioperative care of women undergoing abdominal-based microvascular breast reconstruction in the United Kingdom (The optiFLAPP Study)
| Autor: | OptiFLAPP Collaborative, Gardiner, MD, Giblin, V, Highton, D, Jain, A, Jeevan, R, Jhanji, S, Kwasnicki, RM, Mosahebi, A, Martin, D, Sadideen, H, Skillman, J, Acquaah, F, Cato, L, Coventry, D, Geoghegan, L, Iqbal, F, Lim, D, McCaughey, P, Pancholi, J, Sinha, Y, Stanley, G, Twoon, M, Berry, B, Borelli, M, Chan, V, Chauhan, P, Conci, E, Coulson, R, Dreyer, S, Dynes, K, Evans, E, Gallagher, S, Garner, J, Kane, T, Lafford, G, Mena, J, Ngyen, U, Nowicka, M, Robinson, D, Suresh, R, Tarassoli, SP, Teoh, V, Way, B |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Microsurgery optiFLAPP Collaborative medicine.medical_treatment Mammaplasty Rectus Abdominis Breast Neoplasms 030230 surgery Deep inferior epigastric perforator flap 03 medical and health sciences 0302 clinical medicine Breast cancer Clinical Protocols medicine Humans Breast reconstruction Perioperative Enhanced recovery after surgery Protocol (science) Analgesics Intraoperative Care business.industry Wound Closure Techniques General surgery Anti-Inflammatory Agents Non-Steroidal Graft Survival Hemodynamics 1103 Clinical Sciences medicine.disease Bandages United Kingdom Surgery 030220 oncology & carcinogenesis Perioperative care Fluid Therapy Female business Perforator Flap Mastectomy |
| Zdroj: | Journal of plastic, reconstructiveaesthetic surgery : JPRAS. 72(1) |
| ISSN: | 1878-0539 |
| Popis: | Introduction Abdominal-based microvascular breast reconstruction constitutes approximately one fifth of reconstructions following mastectomy for breast cancer. Enhanced recovery after surgery (ERAS) protocols have been implemented to improve patient care. The aim of this project was to identify variation in the perioperative care of women undergoing microvascular breast reconstruction to inform development of an ERAS protocol. Methods Surveys were developed for plastic surgeons, anaesthetists and the lead clinician for breast reconstruction at each unit. These assessed most aspects of perioperative care. A team of medical student collaborators was identified. This team created a list of surgeons and anaesthetists in the United Kingdom by unit. REDCap was used to record their responses. Results Nineteen (19/39, 49%) lead clinicians, 83 (83/134, 62%) plastic surgeons and 71 (71/100, 71%) anaesthetists from units across the UK completed the surveys. Marked variation was identified in the clinician responses when compared with the national and international guidance. This variation covered many aspects of patient care including antibiotic and fluid prescribing, surgical technique, postoperative care and recording of patient outcomes. Conclusions The optiFLAPP national practice survey has demonstrated variation in the perioperative care of women undergoing abdominal-based microvascular breast reconstruction. We propose a large prospective audit to assess current protocols and support development of randomised controlled trials. |
| Databáze: | OpenAIRE |
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