Annals of plastic surgery · 2025
Impact of Cannabis Use on Deep Inferior Epigastric Perforator Autologous Breast Reconstruction: analysis of 719 patients and 1148 flaps: Impact of Cannabis Use in DIEP Reconstruction.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Park John B, Escobar-Domingo Maria J, Tobin Micaela, Lee Daniela, Mahmoud Amir-Ala, Rahmani Benjamin, Adebagbo Oluwaseun, Fanning James E, Posso Agustin N, Bloom Joshua A, Cauley Ryan P, Lee Bernard T
Аннотация
INTRODUCTION: Given recent efforts to legalize and decriminalize recreational marijuana, its use has become increasingly common in the plastic surgery patient population. Although cannabis use has generally been considered lower risk than use of other recreational substances, recent studies have suggested it may be associated with an increased surgical complication rate. The aims of our study were to (1) characterize the extent of cannabis use and (2) determine the clinical effects of cannabis use in our cohort of patients undergoing autologous breast reconstruction using deep inferior epigastric perforator (DIEP) flaps.
METHODS: A retrospective study was conducted in adult patients who underwent autologous breast reconstruction using DIEP flaps between January 2015 and December 2023 by 5 plastic surgeons at our institution. Patients were divided into 2 groups of cannabis users and nonusers. Univariate and multivariable analyses were performed to assess outcomes between the groups.
RESULTS: A total of 87 cannabis users (12.1%) and 632 nonusers were included. A 5-fold increase in the proportion of cannabis users from 2015 to 2023 was found. Cannabis users were significantly younger (47.5 vs 51.7, P < 0.001) and had a significantly higher body mass index (30.5 vs 28.9, P = 0.012). Postoperatively, cannabis users had a significantly higher readmission rate (8.0% vs 3.2%, P = 0.035) and longer time to last abdominal drain removal (21 vs 17 days, P < 0.001). After controlling for confounders, multivariable logistic regression revealed cannabis use as a significant risk factor for postoperative general hematoma (OR: 3.078, confidence interval [95% CI]: 1.265-7.491, P = 0.013), breast hematoma (OR: 3.098, 95% CI: 1.197-8.020, P = 0.020), and readmission (OR: 2.865, 95% CI: 1.098-7.475, P = 0.031).
CONCLUSION: To our knowledge, this is the largest study examining the effects of cannabis use in patients receiving DIEP breast reconstruction. Our findings suggest that cannabis users undergoing DIEP breast reconstruction may require greater postoperative care and attention.
METHODS: A retrospective study was conducted in adult patients who underwent autologous breast reconstruction using DIEP flaps between January 2015 and December 2023 by 5 plastic surgeons at our institution. Patients were divided into 2 groups of cannabis users and nonusers. Univariate and multivariable analyses were performed to assess outcomes between the groups.
RESULTS: A total of 87 cannabis users (12.1%) and 632 nonusers were included. A 5-fold increase in the proportion of cannabis users from 2015 to 2023 was found. Cannabis users were significantly younger (47.5 vs 51.7, P < 0.001) and had a significantly higher body mass index (30.5 vs 28.9, P = 0.012). Postoperatively, cannabis users had a significantly higher readmission rate (8.0% vs 3.2%, P = 0.035) and longer time to last abdominal drain removal (21 vs 17 days, P < 0.001). After controlling for confounders, multivariable logistic regression revealed cannabis use as a significant risk factor for postoperative general hematoma (OR: 3.078, confidence interval [95% CI]: 1.265-7.491, P = 0.013), breast hematoma (OR: 3.098, 95% CI: 1.197-8.020, P = 0.020), and readmission (OR: 2.865, 95% CI: 1.098-7.475, P = 0.031).
CONCLUSION: To our knowledge, this is the largest study examining the effects of cannabis use in patients receiving DIEP breast reconstruction. Our findings suggest that cannabis users undergoing DIEP breast reconstruction may require greater postoperative care and attention.