No abstract

Background Thrombosis is a common cause of flap failure in microvascular tissue transfer, which questions the effects of anemia on this outcome. This article seeks to contribute a large, multi‐institutional data analysis to this debate. Methods Free tissue transfer patients were identified in the National Surgical Quality Improvement database through a specified Current Procedural Terminology algorithm. Bivariate analysis compared anemic and nonanemic groups with respect to flap failure and other outcomes. Multivariable logistic regression was used to determine risk factors for flap failure. Results Of the 864 patients who met inclusion criteria, 244 were anemic and 620 were not. Bivariate analysis showed no significant difference between groups with respect to flap failure (3.28% vs. 4.03%, P = 0.0603). Multivariate regression analysis supported this (OR 95% CI = 0.371–1.912). Conclusions These findings, based on the largest sample in the literature, show anemia is neither a predictor of free tissue transfer failure nor is it protective. © 2013 Wiley Periodicals, Inc. Microsurgery 33:432–438, 2013.

This is the first study of readmission rates after breast reconstruction. Knowledge of specific risk factors for readmission may improve patient outcomes, steer strategies for optimizing reconstructive outcomes, and minimize readmissions.

Elective breast surgery is a safe procedure with an extremely low incidence of life-threatening complications and mortality. Comprehensive data collated from the NSQIP initiative add to the literature, and the findings of this multi-institutional study may help further guide patient education and expectations on potentially deleterious outcomes.

B reast reconstruction can help moderate the distressing postoperative changes in body image and the quality of life of breast cancer patients undergoing mastectomy (1-4). In particular, the literature has shown aesthetic results following reconstruction to be a major contributor to patient satisfaction and overall quality of life (5). With numerous reconstruction techniques currently available, myriad studies have detailed the postoperative surgical and cosmetic outcomes of such methods. In addition, factors that may influence final aesthetic results, such as body mass index (BMI), preoperative and postoperative radiation, and age, have also been assessed (6-21). However, little data regarding the impact of postoperative complications on aesthetic outcomes of breast reconstruction exist (22). Does having a complication necessarily mean an adverse aesthetic outcome? We endeavored to track aesthetic outcomes following implant reconstruction in patients who experienced a complication. Studies have shown that complications following surgery can negatively impact a patient's health status, extend hospital stays and lead to higher medical bills (23-26). The potential ramifications of complications on local vasculature and wound healing may be of particular importance in the reconstruction population, in which improved aesthetic outcomes enhance a patient's self image and well-being. To date, there has been little investigation into whether complications actually