ArticlePlastic and reconstructive surgery2017
Is Enhanced Recovery the New Standard of Care in Microsurgical Breast Reconstruction?
Article in Plastic and reconstructive surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 5 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Liposomal Bupivacaine in Transversus Abdominis Plane Block for Postoperative Pain Control After Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis.Microsurgery · 2025Pooled it
- Clinical pathways for secondary care and the effects on professional practice, patient outcomes, length of stay and hospital costs.The Cochrane database of systematic reviews · 2025Pooled it
- Impact of rapid rehabilitation surgery on perioperative nursing in patients undergoing cardiac surgery: A meta-analysis.Journal of cardiac surgery · 2022Pooled it
- Enhanced Recovery Pathways for Flap-Based Reconstruction: Systematic Review and Meta-Analysis.Aesthetic plastic surgery · 2021Pooled it
- Enhanced Recovery After Surgery for Breast Reconstruction: Pooled Meta-Analysis of 10 Observational Studies Involving 1,838 Patients.Frontiers in oncology · 2019Pooled it
- Faster Return to Daily Activities and Better Pain Control: A Prospective Study of Enhanced Recovery After Surgery Protocol in Breast Augmentation.Aesthetic plastic surgery · 2023Trial
- Optimizing Pain Management in Autologous Breast Reconstruction: Intravenous Ketorolac in the Enhanced Recovery After Surgery Pathway.Plastic and reconstructive surgery. Global open · 2026Article
- Decreasing Time to Definitive Breast Reconstruction: National Trends and Patient-Level Predictors.Annals of surgical oncology · 2026Article
- Review
- Moving Toward the Outpatient DIEP Flap: Factors Influencing Early Discharge.Plastic and reconstructive surgery · 2025Article
- Intrathecal Morphine vs Paravertebral Nerve Blocks for Analgesia After Breast Reconstruction With Abdominally Based Free Flaps.Aesthetic surgery journal · 2025Article
- Perioperative Venous Thromboembolism Chemoprophylaxis Does Not Increase Risk of Complications in Free Flap Breast Reconstruction.Journal of surgical oncology · 2025Article
- Long-Term Opioid Use After Free Flap Breast Reconstruction: Incidence and Associated Factors.Plastic surgery (Oakville, Ont.) · 2025Article
- ERAS-Based Anesthetic Management of Patients Undergoing Abdominal-Based Free Flap Breast Reconstruction: A Narrative Review.JPRAS open · 2024Review
- Enhanced Recovery Protocol Decreases Postoperative Opioid Use after Penile Inversion Vaginoplasty.Plastic and reconstructive surgery. Global open · 2024Article
- The effect of a local anesthetic cocktail in a serratus anterior plane and PECS 1 block for implant-based breast reconstruction.JPRAS open · 2024Article
- Microsurgical breast reconstruction in the United States: a narrative review of the current state.Gland surgery · 2024Review
- Liposomal Bupivacaine Analgesia in Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Retrospective Cohort Study.Plastic and reconstructive surgery. Global open · 2024Article
- The Cost-effectiveness of Enhanced Recovery after Surgery Protocols in Abdominally Based Autologous Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2024Article
- Moving the needle: a narrative review of enhanced recovery protocols in breast reconstruction.Annals of translational medicine · 2023Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAt present, there are limited data available regarding the use and feasibility of enhanced recovery pathways for patients undergoing microsurgical breast reconstruction. The authors sought to assess patient outcomes before and after the introduction of an enhanced recovery pathway that was adopted at a single cancer center.
methodsA multidisciplinary enhanced recovery pathway was developed for patients undergoing deep inferior epigastric perforator or free transverse rectus abdominis myocutaneous flap breast reconstruction. Core elements of the enhanced recovery pathway included substituting intravenous patient-controlled analgesia with ketorolac and transversus abdominis plane blocks using liposomal bupivacaine, as well as intraoperative goal-directed fluid management. Patients who underwent surgery between April and August of 2015 using the enhanced recovery pathway were compared with a historical control cohort. The primary endpoints were hospital length of stay and total postoperative opioid consumption.
resultsIn total, 91 consecutive patients were analyzed (enhanced recovery pathway, n = 42; pre-enhanced recovery pathway, n = 49). Mean hospital length of stay was significantly shorter in the enhanced recovery pathway group than in the pre-enhanced recovery pathway group (4.0 days versus 5.0 days; p < 0.0001). Total postoperative morphine equivalent consumption was also lower in the enhanced recovery pathway group (46.0 mg versus 70.5 mg; p = 0.003). There was no difference in the incidence of 30-day complications between the groups (p = 0.6).
conclusionThe adoption of an enhanced recovery pathway for deep inferior epigastric perforator and transverse rectus abdominis myocutaneous flap reconstruction by multiple surgeons significantly decreased opioid consumption and reduced length of stay by 1 day. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.