ArticleAnnals of surgical oncology2023
Complications, Costs, and Healthcare Resource Utilization After Staged, Delayed, and Immediate Free-Flap Breast Reconstruction: A Longitudinal, Claims-Based Analysis.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 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
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Outcomes of Air Versus Saline-filled Breast Expanders: A Systematic Review and Meta-analysis.Aesthetic plastic surgery · 2025Pooled it
- Postmastectomy Breast Reconstruction in Patients with Non-Metastatic Breast Cancer: An Ontario Health (Cancer Care Ontario) Clinical Practice Guideline.Current oncology (Toronto, Ont.) · 2025Guideline
- Postmastectomy Breast Reconstruction in Patients with Non-Metastatic Breast Cancer: A Systematic Review.Current oncology (Toronto, Ont.) · 2025Pooled it
- Beyond expansion: the strategic role of the tissue expander in immediate breast reconstruction.JPRAS open · 2026Review
- Prophylactic Superdrained Deep Inferior Epigastric Perforator Flap: Systematic Review of Survival and Morbidity.Plastic and reconstructive surgery. Global open · 2026Article
- Economic value of ribociclib in early breast cancer in the United States.Journal of managed care & specialty pharmacy · 2026Article
- Balancing Risk and Reconstruction: A Comprehensive Review of Complications in Delayed Breast Reconstruction.Journal of clinical medicine · 2026Review
- Review
- Effects of platelet-rich plasma on cutaneous flap healing in rabbits: a pilot comparative experimental study with adipose tissue.Scientific reports · 2026Article
- Radiation and Reconstructive Failure: Long-Term Outcomes in Two-Stage Flap Versus Implant Breast Reconstruction.Annals of surgical oncology · 2026Article
- Impact of Sociodemographic and Clinical Factors on Postoperative Outcomes Following Immediate Postmastectomy Autologous Breast Reconstruction.Annals of surgical oncology · 2026Article
- Patient-reported outcomes after immediate and delayed DIEP-flap breast reconstruction in the setting of post-mastectomy radiation therapy-results of the multicenter UMBRELLA breast cancer cohort.Breast cancer research and treatment · 2025Article
- Artificial Intelligence in Breast Reconstruction: A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- Article
- Air or Saline? A Propensity Score-Matched Analysis on the Effect of Tissue Expander Fill on Complications in Immediate Breast Reconstruction.Annals of surgical oncology · 2023Article
- ASO Author Reflections: Initial Tissue Expander Fill with Air Reduces Complications in Immediate Breast Reconstruction.Annals of surgical oncology · 2023Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThere is a lack of consensus detailing the optimal approach to free-flap breast reconstruction when considering immediate, delayed, or staged techniques. This study compared costs, complications, and healthcare resource utilization (HCRU) across staged, delayed, and immediate free-flap breast reconstruction. PATIENTS AND
methodsRetrospective study using MarketScan databases to identify women who underwent mastectomies and free-flap reconstructions between 2014 and 2018. Complications, costs, and HCRU [readmission, reoperation, emergency department (ED) visits] occurring 90 days after mastectomy and 90 days after free flap were compared across immediate, delayed, and staged reconstruction.
resultsOf 3310 women identified, 69.8% underwent immediate, 11.7% underwent delayed, and 18.5% underwent staged free-flap reconstruction. Staged reconstruction was associated with the highest rate (57.8% staged, 42.3% delayed, 32.0% immediate; p < 0.001) and adjusted relative risk [67% higher than immediate (95% CI: 49-87%; p < 0.001)] of surgical complications. Staged displayed the highest HCRU (staged 47.9%, delayed, 38.4%, immediate 25.2%; p < 0.001), with 16.5%, 30.7%, and 26.5% of staged patients experiencing readmission, reoperation, or ED visit, respectively. The adjusted probability of HCRU was 206% higher (95% CI: 156-266%; p < 0.001) for staged compared with immediate. Staged had the highest mean total cost (staged $106,443, delayed $80,667, immediate $76,756; p < 0.001) with regression demonstrating the adjusted mean cost for staged is 31% higher (95% CI: 23-39%; p < 0.001) when compared with immediate.
conclusionsStaged free-flap reconstruction is associated with increased complications, costs, and HCRU, while immediate demonstrated the lowest. The potential esthetic benefits of a staged approach should be balanced with the increased risk for adverse events after surgery.
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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.