Plastic and Reconstructive Surgery, Global Open (Jul 2023)

Patient Experience and Clinical Outcomes after Same-day Outpatient Mastectomy and Immediate Breast Reconstruction Protocol during the Global Pandemic

  • Anita T. Mohan, MBBS, PhD, MBA,
  • Taleen A. MacArthur, MD,
  • Brenna Murphy, MD,
  • Allisa J. Song, BA,
  • Hiba Saifuddin, MD,
  • Amy Degnim, MD,
  • William S. Harmsen, MS,
  • Jorys Martinez-Jorge, MD,
  • James W. Jakub, MD,
  • Aparna Vijayasekaran, MBBS, MSc

DOI
https://doi.org/10.1097/GOX.0000000000005183
Journal volume & issue
Vol. 11, no. 7
p. e5183

Abstract

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Background:. The coronavirus disease 2019 (COVID-19) pandemic provoked rapid changes in clinical practice to accommodate mandated restrictions within healthcare delivery. This study reviewed patient-reported experiences and clinical outcomes after implementation of a same-day discharge protocol after mastectomy with immediate alloplastic breast reconstruction compared with our historical overnight stay protocol. Methods:. This is a retrospective single-institution study of consecutive patients who underwent mastectomy and immediate alloplastic reconstruction between July 2019 and November 2020. A postoperative survey was completed by patients to evaluate satisfaction with perioperative communications, recovery, and their overall experience. Results:. A total of 302 patients (100% women) underwent mastectomy and immediate alloplastic reconstruction (174 pre-COVID-19, 128 during COVID-19). During COVID-19, 71% of patients were scheduled for a same-day discharge, among which 89% were successfully discharged the same day. Compared with pre-COVID-19, there were no differences in type of surgery, operative times, pain scores, 30-day readmission, or unplanned visits (all P > 0.05) during the COVID-19 pandemic. Compared with pre-COVID-19, patients during the pandemic reported comparable satisfaction with their care experience and postoperative recovery (56% survey response rate). Patient satisfaction was also similar between those discharged the same day (n = 81) versus the next day (n = 47) during COVID-19. Conclusions:. Same-day discharge is feasible, safe, and can provide similar patient-reported satisfaction and outcomes compared with traditional overnight stay. These data highlight the ability to deliver adaptable, high-quality breast cancer care, within the constraints of a global pandemic.