Abstract
Background: Surgical breast reconstruction is an integral part of cancer treatment but must not compromise oncological safety. Patient-dependent risk factors (smoking, BMI, etc.) are said to influence perioperative outcomes and have often been investigated. Here, we analyzed independent perioperative risk factors for increased postoperative blood loss or drainage fluid volume loss and their possible impact. Methods: Patients undergoing breast reconstructions after breast cancer with either tissue expanders, definitive breast implants, or autologous breast reconstruction were analyzed. The collected data on patients’ characteristics, blood, and drainage fluid loss were correlated and statistically investigated. Results: Traditional patient-dependent risk factors did not influence blood loss or drainage volumes. On the contrary, patients with preoperative anemia had significantly higher drainage outputs compared to non-anemic patients (U = 2448.5; p = 0.0012). The administration of low molecular weight heparin showed a tendency of increased drainage output. Similar correlations could be seen in prolonged procedure time, all of which contributed to prolonged hospital stay (τb = 0.371; p < 0.00001). Conclusions: Preoperative anemia is one of the most critical factors influencing postoperative drainage fluid output. Previously assumed patient-dependent risk factors did not affect drainage output. Preoperative anemia must be monitored, and if possible, treated preoperatively to reduce postoperative morbidity.
Highlights
Breast cancer is the most common cancer among women in industrial countries [1,2,3,4]
359 breast reconstructions due to breast cancer in 297 patients were identified during the study period
Our findings indicate that common risk factors such as age or weight did not affect blood or drainage fluid loss and did not lead to prolonged hospital treatment
Summary
Breast cancer is the most common cancer among women in industrial countries [1,2,3,4]. Substantial progress in diagnosis and treatment has been achieved, the complete removal of the breast gland via mastectomy is still often necessary Without reconstruction, these procedures often leave women physiologically scarred, leading to dire psychological consequences. Identifying the perioperative risk factors for prolonged wound healing or hospital stay are of great importance to potentially optimize the postoperative course and minimize the above risks Some of these aspects are oncology-related (e.g., mastectomy type, or axillary dissection) and cannot be influenced, whereas others are not and may be subject to optimization [5,6,7,8,9,10,11]. We analyzed independent perioperative risk factors for increased postoperative blood loss or drainage fluid volume loss and their possible impact. Preoperative anemia must be monitored, and if possible, treated preoperatively to reduce postoperative morbidity
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