Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Implementation of high-intensity theatre (HIT) lists in breast reconstruction to reduce elective plastic surgery waiting times.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Allan Anna Yarlini, Iyer Hari, Kapila Ayush, Burke Emily, Chasapi Maria, Gianchandani Ayushi, Cheung Lok Ka, Rahman Shakeel Mohammed, El-Boghdadly Kariem, Ahmad Imran, Mughal Maleeha Hameed, Mohanna Pari-Naz
Аннотация
INTRODUCTION: The COVID-19 pandemic left surgical specialties with unprecedented backlogs, with plastic surgery experiencing a 96.9% increase in waiting-list times between January 2020 and December 2023. To address this, we implemented a high-intensity theatre (HIT) list programme, adapted from other surgical specialties.
METHODS: HIT lists were implemented over two five-day periods in July 2023 and March 2024.
RESULTS: Forty-nine patients underwent surgery: 19 breast reconstructions (28 flaps: 23 deep inferior epigastric artery perforator and 5 profunda artery perforator), 46 secondary breast procedures and 4 miscellaneous operations. Mean microsurgical-case operative time was 279 min, with no significant difference between unilateral and bilateral cases, and an average 12.5-min turnaround time between the cases. There was 1 flap take-back (2%) for breast haematoma evacuation with no flap compromise. Operative throughput per list more than doubled, and theatre start times were consistently earlier. There was a statistically significant improvement in staff-reported satisfaction, and BREAST-Q patient-reported outcomes were comparable to that of patients treated on conventional operating lists.
CONCLUSION: This is the first reported adaptation of the HIT list model for microsurgical breast reconstruction, demonstrating that it is safe, efficient and scalable. Our approach accommodated a heterogenous case mix and delivered a 1.5-fold increase in efficiency per operating list whilst maintaining excellent surgical outcomes and patient-reported satisfaction. Multidisciplinary collaboration and meticulous planning were vital to success. This experience serves as a blueprint worldwide, illustrating how HIT lists can effectively tackle post-pandemic surgical backlogs, streamline essential surgical interventions and deliver high-quality care at scale within the existing constrained healthcare infrastructure.
METHODS: HIT lists were implemented over two five-day periods in July 2023 and March 2024.
RESULTS: Forty-nine patients underwent surgery: 19 breast reconstructions (28 flaps: 23 deep inferior epigastric artery perforator and 5 profunda artery perforator), 46 secondary breast procedures and 4 miscellaneous operations. Mean microsurgical-case operative time was 279 min, with no significant difference between unilateral and bilateral cases, and an average 12.5-min turnaround time between the cases. There was 1 flap take-back (2%) for breast haematoma evacuation with no flap compromise. Operative throughput per list more than doubled, and theatre start times were consistently earlier. There was a statistically significant improvement in staff-reported satisfaction, and BREAST-Q patient-reported outcomes were comparable to that of patients treated on conventional operating lists.
CONCLUSION: This is the first reported adaptation of the HIT list model for microsurgical breast reconstruction, demonstrating that it is safe, efficient and scalable. Our approach accommodated a heterogenous case mix and delivered a 1.5-fold increase in efficiency per operating list whilst maintaining excellent surgical outcomes and patient-reported satisfaction. Multidisciplinary collaboration and meticulous planning were vital to success. This experience serves as a blueprint worldwide, illustrating how HIT lists can effectively tackle post-pandemic surgical backlogs, streamline essential surgical interventions and deliver high-quality care at scale within the existing constrained healthcare infrastructure.