Implementing our microsurgical breast reconstruction enhanced recovery after surgery pathway: Consensus obstacles and recommendations

Jill P. Stone, Charalampos Siotos, Samuel Sarmiento, Claire Temple-Oberle, Oluseyi Aliu, Damon S. Cooney, Kristen P. Broderick, Justin M. Sacks, Michele A. Manahan, Gedge D. Rosson

Research output: Contribution to journalArticlepeer-review

Abstract

Enhanced recovery after surgery pathways are well established in other surgical specialties but are relatively new in plastic surgery. These guidelines focus on improving patient care by incorporating evidence-based recommendations. Length of stay is shorter, and overall hospital costs are lower without compromising patient satisfaction. When care is standardized, ambiguity is removed and physician acceptance is improved. Yet, implementation can be challenging on an institutional level. The Johns Hopkins microsurgical breast reconstruction team identified areas of dogmatic dissonance during 3 focus groups to formalize an enhanced recovery pathway for microsurgical breast reconstruction. Six microsurgeons used nominal group technique to reach consensus. Four discussion points were identified: multidisciplinary buy-in, venous thromboembolism (VTE) chemophylaxis, early feeding, and dietary restrictions. Evidence-based recommendations and our enhanced recovery after surgery protocol are provided.

Original languageEnglish (US)
Article numbere1855
JournalPlastic and Reconstructive Surgery - Global Open
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2019

ASJC Scopus subject areas

  • Surgery

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