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Immediate two-stage implant-based breast reconstruction during the COVID-19 pandemic: retrospective single center study
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Immediate two-stage implant-based breast reconstruction during the COVID-19 pandemic: retrospective single center study
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Immediate two-stage implant-based breast reconstruction during the COVID-19 pandemic: retrospective single center study
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Journal Article
Immediate two-stage implant-based breast reconstruction during the COVID-19 pandemic: retrospective single center study
2023
Overview
Background
Due to fluctuations in contemporary trends for breast reconstruction, we aimed to perform a comparative analysis to assess postoperative outcomes and complications of immediate implant-based breast reconstruction (IBBR) with tissue expander before and over the course of the COVID-19 pandemic.
Methods
Consecutive adult women undergoing total mastectomy and immediate two-stage IBBR with tissue expanders between September 2018 and May 2021 were included. Two groups were compared: reconstructions performed before COVID-19 (pre-pandemic) and reconstructions performed after the implementation of the COVID-19 policies at our institution. We compared postoperative complications and perioperative outcomes (e.g., length of stay, expander volume, time for definitive implant) between groups.
Results
One hundred fourteen patients representing 192 reconstructions with expanders were included. One-hundred twenty-eight (66.6%) were performed before the COVID-19 pandemic, while 64 (33.3%) were performed during the pandemic. A larger proportion of reconstructions performed during the pre-pandemic era had a prolonged length of stay (≥ 2 days) compared to reconstructions performed during the COVID-19 pandemic (43% versus 9.4%,
p
< .001). The median time from immediate IBBR to initiate outpatient expansions (22 days [IQR, 15–34];
p
= 0.45) and to conclude outpatient expansion was (52 days [IQR, 40–76];
p
= 0.85) comparable between groups. The rates of 30-day complications and rates of complications during the expansion period were similar between groups.
Conclusion
Due to adjustments in perioperative management and the implementation of institutional and state recommendations, IBBR with tissue expander during the COVID-19 pandemic exhibited a reduced length of stay compared to pre-pandemic reconstructions without increased morbidity.
Level of evidence:
Level IV, Risk/Prognostic
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
