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Plast Aesthet Res 2018;5:6 I http://dx.doi.org/10.20517/2347-9264.2018.08 Page 9 of 17

14. Predictors of complications following breast reduction surgery: A National Surgical
Quality Improvement Program study of 16,812 cases

Daniel P. Donato, Andrew M. Simpson, Alvin C. Kwok, Jayant P. Agarwal

University of Utah

Aim: Breast reduction is one of the most common procedures performed by plastic surgeons. Despite good
outcomes and high patient satisfaction, there is little national data examining the predictors leading to
complications in this patient population. We accessed a national outcomes database to examine these factors.

Methods: This is a retrospective study examining the National Surgical Quality Improvement Program
database from 2006 through 2015. Patients undergoing primary breast reduction were identified. Patients
undergoing any cancer-related procedures were excluded. We identified patient-related and procedure
related factors for analysis. Univariate and multivariate logistic regression analysis were used to identify
independent predictors of complications.

Results: In total16,812 individual cases were identified. The overall complication rate for the cohort
was 6.2% and the major complication rate was 3.0%. Diabetes, bleeding disorder, hypertension, obesity,
smoking, steroid use and prolonged operative time were associated with increased risk of complications
(P < 0.05). Concurrent body contouring was a predictor of increased major complications, however
liposuction was not.

Conclusion: Common surgical risk factors are associated with complications in breast reduction surgery.
Although liposuction is not an independent risk factor, concurrent body contouring is associated with
increased complications. Surgeons should be aware of these associations when discussing breast reduction
with patients.

15. Minimizing length of stay, narcotic use, operative times and complications combining
an ERAS protocol to a two team approach in microsurgical breast reconstruction

Harry Salinas, Miguel Medina, Elizabeth Hunter

Miami Cancer Institute - Baptist Health South Florida

Aim: Enhanced recovery after surgery (ERAS) pathways are being adopted to shorten postoperative length
of stay (LOS) and decrease narcotic use. A two-team approach in microsurgical breast reconstruction has
been shown to decrease operative times and complications. The authors sought to compare outcomes in
microsurgical breast reconstruction using a two-team approach before and after the institution of an ERAS
protocol.

Methods: Retrospective review of 44 consecutive patients undergoing free DIEP reconstruction with a
continuous two team approach undergoing DIEP flap breast reconstruction. Twenty-one patients had an
ERAS protocol consisting of intraoperative TAP block, intraoperative Ketorolac that is continued on a
standing basis for 48 h and Q6h scheduled Tylenol.