Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstruction

Background: Enhanced recovery after surgery protocols are successfully implemented in different surgical specialties, but a specific protocol for autologous breast reconstruction is missing. The aim of this study was to determine whether an enhanced recovery after surgery (ERAS) protocol contributes...

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Main Authors: N. Gort, B.G.I. van Gaal, H.J.P. Tielemans, D.J.O. Ulrich, S. Hummelink
Format: Article
Language:English
Published: Elsevier 2021-12-01
Series:Breast
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0960977621004409
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author N. Gort
B.G.I. van Gaal
H.J.P. Tielemans
D.J.O. Ulrich
S. Hummelink
author_facet N. Gort
B.G.I. van Gaal
H.J.P. Tielemans
D.J.O. Ulrich
S. Hummelink
author_sort N. Gort
collection DOAJ
description Background: Enhanced recovery after surgery protocols are successfully implemented in different surgical specialties, but a specific protocol for autologous breast reconstruction is missing. The aim of this study was to determine whether an enhanced recovery after surgery (ERAS) protocol contributes to a reduced length of stay without an increase in postoperative complications for patients undergoing a DIEP flap breast reconstruction. Materials en methods: The effect of the ERAS protocol was examined using a single-center patient-control study comparing two groups of patients. Patients who underwent surgery between November 2017 and November 2018 using the ERAS protocol were compared with a historical control group (pre-ERAS) who underwent surgery between November 2016 and November 2017. The primary outcome measure was hospital length of stay. Secondary outcome measures were postoperative pain and postoperative complications. Results: 152 patients were included (ERAS group, n = 73; control group, n = 79). Mean hospital length of stay was significantly shorter in the ERAS group than in the control group (5 vs. 6 days, p < 0.001). The average pain score was 1.73 in de the ERAS group compared to 2.17 in the control group (p = 0.032). There were no significant differences between the groups in postoperative complications. The ERAS group experienced less constipation (41 vs. 25 patients, p = 0.028). Conclusion: An enhanced recovery after surgery protocol contributes an accelerated postoperative recovery of patients undergoing a DIEP flap breast reconstruction. In this study a significant decrease was found in hospital length of stay, patient-reported pain score and adverse health issues.
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spelling doaj.art-1507751a501c40bb9abe7c5f8ac527d82022-12-21T19:33:20ZengElsevierBreast1532-30802021-12-01605357Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstructionN. Gort0B.G.I. van Gaal1H.J.P. Tielemans2D.J.O. Ulrich3S. Hummelink4Radboud University Medical Center, Dept. of Plastic Surgery, Nijmegen, the Netherlands; Corresponding author. Department of Plastic Surgery (hp 634), Department of Plastic Surgery (hp 634), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands; Radboud University Medical Center, Radboud Institute for Health Science, IQ Healthcare, Nijmegen, the NetherlandsRadboud University Medical Center, Dept. of Plastic Surgery, Nijmegen, the NetherlandsRadboud University Medical Center, Dept. of Plastic Surgery, Nijmegen, the NetherlandsRadboud University Medical Center, Dept. of Plastic Surgery, Nijmegen, the NetherlandsBackground: Enhanced recovery after surgery protocols are successfully implemented in different surgical specialties, but a specific protocol for autologous breast reconstruction is missing. The aim of this study was to determine whether an enhanced recovery after surgery (ERAS) protocol contributes to a reduced length of stay without an increase in postoperative complications for patients undergoing a DIEP flap breast reconstruction. Materials en methods: The effect of the ERAS protocol was examined using a single-center patient-control study comparing two groups of patients. Patients who underwent surgery between November 2017 and November 2018 using the ERAS protocol were compared with a historical control group (pre-ERAS) who underwent surgery between November 2016 and November 2017. The primary outcome measure was hospital length of stay. Secondary outcome measures were postoperative pain and postoperative complications. Results: 152 patients were included (ERAS group, n = 73; control group, n = 79). Mean hospital length of stay was significantly shorter in the ERAS group than in the control group (5 vs. 6 days, p < 0.001). The average pain score was 1.73 in de the ERAS group compared to 2.17 in the control group (p = 0.032). There were no significant differences between the groups in postoperative complications. The ERAS group experienced less constipation (41 vs. 25 patients, p = 0.028). Conclusion: An enhanced recovery after surgery protocol contributes an accelerated postoperative recovery of patients undergoing a DIEP flap breast reconstruction. In this study a significant decrease was found in hospital length of stay, patient-reported pain score and adverse health issues.http://www.sciencedirect.com/science/article/pii/S0960977621004409Autologous breast reconstructionFree flapDIEP flapEnhanced recovery after surgeryERASMicrosurgery
spellingShingle N. Gort
B.G.I. van Gaal
H.J.P. Tielemans
D.J.O. Ulrich
S. Hummelink
Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstruction
Breast
Autologous breast reconstruction
Free flap
DIEP flap
Enhanced recovery after surgery
ERAS
Microsurgery
title Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstruction
title_full Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstruction
title_fullStr Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstruction
title_full_unstemmed Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstruction
title_short Positive effects of the enhanced recovery after surgery (ERAS) protocol in DIEP flap breast reconstruction
title_sort positive effects of the enhanced recovery after surgery eras protocol in diep flap breast reconstruction
topic Autologous breast reconstruction
Free flap
DIEP flap
Enhanced recovery after surgery
ERAS
Microsurgery
url http://www.sciencedirect.com/science/article/pii/S0960977621004409
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