Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
The 24-hour DIEP challenge: How ERAS redefines recovery in microsurgical breast reconstruction.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Longo Benedetto, Giacalone Martina, D'Orsi Gennaro, Vannucchi Lisa, Gagliano Elettra, Caiazza Giordana, Vanni Gianluca, Buonomo Oreste Claudio, Cervelli Valerio
Аннотация
INTRODUCTION: Enhanced recovery after surgery (ERAS) protocols have reshaped perioperative management in microsurgical breast reconstruction. However, evidence supporting safe and reproducible ultra-early discharge following deep inferior epigastric perforator (DIEP) flap reconstruction remains limited. We evaluated a DIEP-specific ERAS pathway designed to facilitate 24-hour discharge.
METHODS: A retrospective analysis of a prospective institutional database included consecutive patients undergoing unilateral/bilateral DIEP flap breast reconstruction between January 2023 and July 2025. Outcomes before (pre-ERAS) and after ERAS implementation were compared. The primary endpoint was length of stay (LOS); secondary endpoints included operative time, postoperative complications, and patient-reported satisfaction. Multivariable robust regression assessed the independent effect of ERAS on LOS and operative time.
RESULTS: A total of 127 patients (143 flaps) were included (37 pre-ERAS and 90 ERAS). In unilateral reconstructions, LOS decreased from 3.69 ± 1.18 to 1.78 ± 0.80 days (p < 0.001), and in bilateral reconstructions from 6.00 ± 2.92 to 3.18 ± 0.60 days (p = 0.096). Twenty-nine ERAS patients (32.2%) were discharged within 24 h. Operative time was reduced in unilateral (-25.3%) and bilateral (-24.3%) reconstructions (all p < 0.001). ERAS was independently associated with a 50.9% reduction in LOS; body mass index was the only predictor of prolonged hospitalization. Complications rates did not differ between the groups. Patient-reported satisfaction was high and greater among patients discharged within 2 days.
CONCLUSIONS: A structured ERAS pathway enables safe and reproducible 24-hour discharge following DIEP flap breast reconstruction without increasing morbidity. Standardized perioperative care and multidisciplinary coordination optimizes recovery, operative efficiency, and patient satisfaction.
METHODS: A retrospective analysis of a prospective institutional database included consecutive patients undergoing unilateral/bilateral DIEP flap breast reconstruction between January 2023 and July 2025. Outcomes before (pre-ERAS) and after ERAS implementation were compared. The primary endpoint was length of stay (LOS); secondary endpoints included operative time, postoperative complications, and patient-reported satisfaction. Multivariable robust regression assessed the independent effect of ERAS on LOS and operative time.
RESULTS: A total of 127 patients (143 flaps) were included (37 pre-ERAS and 90 ERAS). In unilateral reconstructions, LOS decreased from 3.69 ± 1.18 to 1.78 ± 0.80 days (p < 0.001), and in bilateral reconstructions from 6.00 ± 2.92 to 3.18 ± 0.60 days (p = 0.096). Twenty-nine ERAS patients (32.2%) were discharged within 24 h. Operative time was reduced in unilateral (-25.3%) and bilateral (-24.3%) reconstructions (all p < 0.001). ERAS was independently associated with a 50.9% reduction in LOS; body mass index was the only predictor of prolonged hospitalization. Complications rates did not differ between the groups. Patient-reported satisfaction was high and greater among patients discharged within 2 days.
CONCLUSIONS: A structured ERAS pathway enables safe and reproducible 24-hour discharge following DIEP flap breast reconstruction without increasing morbidity. Standardized perioperative care and multidisciplinary coordination optimizes recovery, operative efficiency, and patient satisfaction.