Enhanced recovery after surgery pathways for deep inferior epigastric perforator flap breast reconstruction: A systematic review and meta-analysis

Pierzchajlo, Noah; Zibitt, Meira; Hinson, Chandler; Stokes, J. Avery; Neil, Zachery D.; Pierzchajlo, Garret; Gendreau, Julian; Buchanan, Patrick J.

doi:10.1016/j.bjps.2023.10.058

Journal of Plastic, Reconstructive & Aesthetic Surgery

2023

DOI: 10.1016/j.bjps.2023.10.058

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Enhanced recovery after surgery pathways for deep inferior epigastric perforator flap breast reconstruction: A systematic review and meta-analysis

Noah Pierzchajlo,

Meira Zibitt,

Chandler Hinson

et al.

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Evaluating Donor Morbidity in ALT and TDAP Flaps With Drainless Closure Compared to Conventional Drain Placement

Lee,

Lee

2024

Microsurgery

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PurposeRecent trends in reconstructive surgery focus on rapid recovery, questioning the necessity of postoperative drains. Although harvesting perforator flaps causes minimal injury to anatomical structures at donor sites, attempts to omit drains have been limited. This study aimed to assess the safety of not using drains after harvesting the anterolateral thigh (ALT) perforators and the thoracodorsal artery perforator (TDAP) flaps.MethodsAll consecutive patients who underwent free ALT or TDAP flap‐based reconstruction between 2020 and 2022 did not have drains placed at the donor site. Their donor morbidities were evaluated, and compared with those who underwent the same operation between 2016 and 2019 with donor drains placed.ResultsThe drainless cohort consisting of 202 cases (159 ALT and 43 TDAP flaps) and the control cohort comprising 119 (52 ALT and 67 TDAP flaps) were analyzed. In ALT flap cases, the drainless cohort, apart from a larger flap dimension, exhibited comparable baseline characteristics to the control. The rates of overall donor complications were comparable between the two cohorts (10.1% vs. 11.5%, p = 0.795), as were rates for specific complications including wound dehiscence (p = 0.751) and seroma (p = 0.999). Multivariable analysis revealed no significant association between omitting drains and increased donor complications. Consistent results were obtained in the analysis for cases using TDAP flaps, with no significant difference between drainless and drain‐using groups (p = 0.297).ConclusionsOmitting drains in the donor site of ALT and TDAP flaps might be safe, not escalading the risks of donor morbidity.

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Evaluating Donor Morbidity in ALT and TDAP Flaps With Drainless Closure Compared to Conventional Drain Placement

Lee,

Lee

2024

Microsurgery

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show abstract