O080 Evaluation of patient post-operative outcomes after deep inferior epigastric perforator (DIEP) flap surgery

Abstract

Abstract Introduction The Deep Inferior Epigastric Perforator (DIEP) flap is considered the gold standard procedure for breast reconstruction. The long-term cosmetic outcomes of the reconstructed breast are unmatched by alternative reconstructive methods, however the donor site morbidity, including pain, scarring and extended recovery periods, require patients to consider their preferred option. Methods There is a paucity of data regarding return to pre-surgical activity timelines, and effect of reconstruction on psychosocial, sexual, and physical wellbeing. After obtaining audit approval, we utilized the Breast-QTM questionnaire to conduct a prospective cohort study. DIEP breast reconstruction patients in a tertiary referral, high-volume centre (N=26) were assessed prior to surgery and at 3 months post-operatively. Results An average of 20.3 days were lost to hospital admissions, follow-up, and post-operative recovery. Of employed patients, 68% had not yet returned to work. For those that did, an average of 6 weeks was required to feel well enough. Additionally, patients reported needing 4.8 weeks to drive again, 4.4 weeks to resume chores, 3.7 weeks to recommence childcare duties and 4.3 weeks to resume exercise. Comparing pre-operative and post-operative Rasch Transformed Scores, patients’ sexual wellbeing score decreased (58.3 to 52.2, p=0.09), while their psychosocial wellbeing score increased (62.1 to 66.7, p=0.16). Qualitatively, patients reported significant challenges impacting return to baseline, particularly involving abdominal scar site, size, and associated healing delays. Conclusion Ultimately, results of our work indicate the need for additional patient supports to improve outcomes, decrease the burden of recovery and time required to return to baseline.