Premium
Co‐surgeons in breast reconstructive microsurgery: What do they bring to the table?
Author(s) -
Haddock Nicholas T.,
Kayfan Samar,
Pezeshk Ronnie A.,
Teotia Sumeet S.
Publication year - 2018
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30191
Subject(s) - medicine , breast reconstruction , seroma , surgery , microsurgery , hematoma , plastic surgery , mammaplasty , general surgery , breast cancer , complication , cancer
Current research within other surgical specialties suggests that a co‐surgeon approach may reduce operative times and complications associated with complex bilateral procedures, possibly leading to improved patient and surgical outcomes. We sought to evaluate the role of the co‐surgery team and its development in free flap breast reconstruction. Methods A retrospective review of free‐flap breast reconstruction by two surgeons from 2011 to 2016 was conducted. We analyzed 128 patients who underwent bilateral‐DIEP breast. Surgical groups were: single‐surgeon reconstruction (SSR; 35 patients), co‐surgery where both surgeons are present for entire reconstruction (CSR‐I; 69 patients), and co‐surgery reconstruction where co‐surgeons appropriately assist in two concurrent or staggered cases (CSR‐II; 24 patients). Efficiency data collected was OR time and patient length‐of‐stay (LOS). The rate of flap‐failure, return to OR, infection, wound breakdown, seroma, hematoma, and PE/DVT were compared. Results Single‐surgeon reconstruction had significantly longer OR time (678 vs. 485 min, P < .0001), LOS (5 vs. 3.9 days, P < .001), higher wound occurrences of the umbilical site that required surgical correction [11.4 percent ( n = 4) vs. 1.5% ( n = 1); P < .043] compared to CSR‐I. Similarly, SSR had significantly longer average OR time (678 vs. 527 min P < .0001), average LOS (5 vs. 4 days, P = .0005) when compared with CSR‐II. There were no total increased patient related complications associated with co‐surgery (CSR‐I or II). Conclusion The addition of a co‐surgeon, even with concurrent surgery, reduces operative time, average patient LOS, and postoperative complications. This work lends a strong credence that co‐surgery model is associated with increased operative efficiency.