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Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations
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 wit...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382235/ https://www.ncbi.nlm.nih.gov/pubmed/30859019 http://dx.doi.org/10.1097/GOX.0000000000001855 |
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author | Stone, Jill P. Siotos, Charalampos Sarmiento, Samuel Temple-Oberle, Claire Aliu, Oluseyi Cooney, Damon S. Broderick, Kristen P. Sacks, Justin M. Manahan, Michele A. Rosson, Gedge D. |
author_facet | Stone, Jill P. Siotos, Charalampos Sarmiento, Samuel Temple-Oberle, Claire Aliu, Oluseyi Cooney, Damon S. Broderick, Kristen P. Sacks, Justin M. Manahan, Michele A. Rosson, Gedge D. |
author_sort | Stone, Jill P. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6382235 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-63822352019-03-11 Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations Stone, Jill P. Siotos, Charalampos Sarmiento, Samuel Temple-Oberle, Claire Aliu, Oluseyi Cooney, Damon S. Broderick, Kristen P. Sacks, Justin M. Manahan, Michele A. Rosson, Gedge D. Plast Reconstr Surg Glob Open Ideas and Innovations 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. Wolters Kluwer Health 2019-01-04 /pmc/articles/PMC6382235/ /pubmed/30859019 http://dx.doi.org/10.1097/GOX.0000000000001855 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Ideas and Innovations Stone, Jill P. Siotos, Charalampos Sarmiento, Samuel Temple-Oberle, Claire Aliu, Oluseyi Cooney, Damon S. Broderick, Kristen P. Sacks, Justin M. Manahan, Michele A. Rosson, Gedge D. Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations |
title | Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations |
title_full | Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations |
title_fullStr | Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations |
title_full_unstemmed | Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations |
title_short | Implementing Our Microsurgical Breast Reconstruction Enhanced Recovery after Surgery Pathway: Consensus Obstacles and Recommendations |
title_sort | implementing our microsurgical breast reconstruction enhanced recovery after surgery pathway: consensus obstacles and recommendations |
topic | Ideas and Innovations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382235/ https://www.ncbi.nlm.nih.gov/pubmed/30859019 http://dx.doi.org/10.1097/GOX.0000000000001855 |
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