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Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire
INTRODUCTION: The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590633/ https://www.ncbi.nlm.nih.gov/pubmed/28768227 http://dx.doi.org/10.1016/j.breast.2017.07.016 |
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author | Mylvaganam, Senthurun Conroy, Elizabeth Williamson, Paula R. Barnes, Nicola L.P. Cutress, Ramsey I. Gardiner, Matthew D. Jain, Abhilash Skillman, Joanna M. Thrush, Steven Whisker, Lisa J. Blazeby, Jane M. Potter, Shelley Holcombe, Christopher |
author_facet | Mylvaganam, Senthurun Conroy, Elizabeth Williamson, Paula R. Barnes, Nicola L.P. Cutress, Ramsey I. Gardiner, Matthew D. Jain, Abhilash Skillman, Joanna M. Thrush, Steven Whisker, Lisa J. Blazeby, Jane M. Potter, Shelley Holcombe, Christopher |
author_sort | Mylvaganam, Senthurun |
collection | PubMed |
description | INTRODUCTION: The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK. METHODS: A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined. RESULTS: 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50–80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0–3.0) and 2.0 plastic surgeons (IQR:1.0–3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures. CONCLUSIONS: The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored. |
format | Online Article Text |
id | pubmed-5590633 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-55906332017-10-01 Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire Mylvaganam, Senthurun Conroy, Elizabeth Williamson, Paula R. Barnes, Nicola L.P. Cutress, Ramsey I. Gardiner, Matthew D. Jain, Abhilash Skillman, Joanna M. Thrush, Steven Whisker, Lisa J. Blazeby, Jane M. Potter, Shelley Holcombe, Christopher Breast Original Article INTRODUCTION: The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK. METHODS: A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined. RESULTS: 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50–80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0–3.0) and 2.0 plastic surgeons (IQR:1.0–3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures. CONCLUSIONS: The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored. Elsevier 2017-10 /pmc/articles/PMC5590633/ /pubmed/28768227 http://dx.doi.org/10.1016/j.breast.2017.07.016 Text en © 2017 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Article Mylvaganam, Senthurun Conroy, Elizabeth Williamson, Paula R. Barnes, Nicola L.P. Cutress, Ramsey I. Gardiner, Matthew D. Jain, Abhilash Skillman, Joanna M. Thrush, Steven Whisker, Lisa J. Blazeby, Jane M. Potter, Shelley Holcombe, Christopher Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire |
title | Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire |
title_full | Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire |
title_fullStr | Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire |
title_full_unstemmed | Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire |
title_short | Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire |
title_sort | variation in the provision and practice of implant-based breast reconstruction in the uk: results from the ibra national practice questionnaire |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590633/ https://www.ncbi.nlm.nih.gov/pubmed/28768227 http://dx.doi.org/10.1016/j.breast.2017.07.016 |
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