ArticleJPRAS open2026
Optimising the unilateral DIEP flap breast reconstruction: A United Kingdom-Netherlands multi-centre comparative study.
Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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1 citing paper in PubMed.
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Authors and funding
10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: The deep inferior epigastric perforator (DIEP) flap represents the gold standard in autologous breast reconstruction; however, it is restricted by prolonged operative duration and substantial demands on inpatient capacity. We compared postoperative outcomes across international centres with differing surgical models and perioperative pathways. Methods: A retrospective, two-centre cohort study was undertaken of unilateral DIEP flap reconstructions performed in the United Kingdom (UK) and the Netherlands (NL). The UK cohort (2018-2022) utilised a single-surgeon model with an enhanced recovery after surgery (ERAS) pathway, whereas the NL cohort (2013-2019) employed a co-surgeon model and lean optimisation without ERAS protocols. Patient demographics, operative characteristics, and postoperative complications were compared. Outcomes were analysed by complication severity (Clavien-Dindo), timing (<30 vs. ≥30 days), and potential predictors. Results: The cohort included 203 patients (203 flaps): 103 from the UK and 100 from NL. Immediate reconstruction predominated in the UK (70% vs. 1%, Conclusions: The present study demonstrates that operative workflow, case-mix, and perioperative pathways may influence efficiency and complication profiles without altering flap survival. Pragmatic improvements include ERAS implementation, co-surgeon operating, lean optimisation, and tailored planning for higher-risk patients.
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