Late-Start Days Increase Total Operative Time in Microvascular Breast Reconstruction

Michael W. Chu, Jason S. Barr, J. Bradford Hill, Katie E. Weichman, Nolan S. Karp, Jamie P. Levine

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Prolonged operative time has been associated with increased postoperative complications and higher costs. Many academic centers have a designated day for didactics that cause cases to start 1 hour later. The purpose of this study is to analyze the late-start effect of microvascular breast reconstructions on operative duration. Methods A retrospective review was performed on all patients who underwent abdomina-based free flap breast reconstruction from 2007 to 2011 and analyzed by those who had surgery on late-start versus normal-start days. Patient demographics, average operative time, postoperative complications, and individual surgeon effects were analyzed. A Student t-test was used to compare operative times with statistical significance set at p < 0.05. A multivariate regression analysis was performed to control for potential confounders. Results A total of 272 patients underwent 461 free flap breast reconstructions. Twenty-one cases were performed on late-start days and 251 cases were performed on normal-start days. Patient demographics and complications were not statistically different between the groups. The average operative time for all reconstructions was 434.3 minutes. The average operative times were significantly longer for late-start days, 517.6 versus 427.3 minutes (p = 0.002). This was true for both unilateral and bilateral reconstructions (432.8 vs. 350.9 minutes, p = 0.05; 551.5 vs. 461.2 minutes, p = 0.007). There were no differences in perioperative complications and multivariate regression showed no statistically significant relationship of confounders to duration of surgery. Conclusion Starting cases 1 hour later can increase operative times. Although outcomes were not affected, we recommend avoiding lengthy procedures on late-start days.

Original languageEnglish (US)
Pages (from-to)401-406
Number of pages6
JournalJournal of Reconstructive Microsurgery
Volume31
Issue number6
DOIs
StatePublished - Feb 4 2015

Fingerprint

Mammaplasty
Operative Time
Free Tissue Flaps
Demography
Abdomen
Multivariate Analysis
Regression Analysis
Students
Costs and Cost Analysis

Keywords

  • autologous breast reconstruction
  • breast reconstruction
  • free flap
  • free tissue transfer
  • late-start
  • microvascular
  • operative duration
  • operative time
  • OR time

ASJC Scopus subject areas

  • Surgery

Cite this

Late-Start Days Increase Total Operative Time in Microvascular Breast Reconstruction. / Chu, Michael W.; Barr, Jason S.; Hill, J. Bradford; Weichman, Katie E.; Karp, Nolan S.; Levine, Jamie P.

In: Journal of Reconstructive Microsurgery, Vol. 31, No. 6, 04.02.2015, p. 401-406.

Research output: Contribution to journalArticle

Chu, Michael W. ; Barr, Jason S. ; Hill, J. Bradford ; Weichman, Katie E. ; Karp, Nolan S. ; Levine, Jamie P. / Late-Start Days Increase Total Operative Time in Microvascular Breast Reconstruction. In: Journal of Reconstructive Microsurgery. 2015 ; Vol. 31, No. 6. pp. 401-406.
@article{e395a3e50fe84ceebe566f14057bcd82,
title = "Late-Start Days Increase Total Operative Time in Microvascular Breast Reconstruction",
abstract = "Background Prolonged operative time has been associated with increased postoperative complications and higher costs. Many academic centers have a designated day for didactics that cause cases to start 1 hour later. The purpose of this study is to analyze the late-start effect of microvascular breast reconstructions on operative duration. Methods A retrospective review was performed on all patients who underwent abdomina-based free flap breast reconstruction from 2007 to 2011 and analyzed by those who had surgery on late-start versus normal-start days. Patient demographics, average operative time, postoperative complications, and individual surgeon effects were analyzed. A Student t-test was used to compare operative times with statistical significance set at p < 0.05. A multivariate regression analysis was performed to control for potential confounders. Results A total of 272 patients underwent 461 free flap breast reconstructions. Twenty-one cases were performed on late-start days and 251 cases were performed on normal-start days. Patient demographics and complications were not statistically different between the groups. The average operative time for all reconstructions was 434.3 minutes. The average operative times were significantly longer for late-start days, 517.6 versus 427.3 minutes (p = 0.002). This was true for both unilateral and bilateral reconstructions (432.8 vs. 350.9 minutes, p = 0.05; 551.5 vs. 461.2 minutes, p = 0.007). There were no differences in perioperative complications and multivariate regression showed no statistically significant relationship of confounders to duration of surgery. Conclusion Starting cases 1 hour later can increase operative times. Although outcomes were not affected, we recommend avoiding lengthy procedures on late-start days.",
keywords = "autologous breast reconstruction, breast reconstruction, free flap, free tissue transfer, late-start, microvascular, operative duration, operative time, OR time",
author = "Chu, {Michael W.} and Barr, {Jason S.} and Hill, {J. Bradford} and Weichman, {Katie E.} and Karp, {Nolan S.} and Levine, {Jamie P.}",
year = "2015",
month = "2",
day = "4",
doi = "10.1055/s-0035-1548740",
language = "English (US)",
volume = "31",
pages = "401--406",
journal = "Journal of Reconstructive Microsurgery",
issn = "0743-684X",
publisher = "Thieme Medical Publishers",
number = "6",

}

TY - JOUR

T1 - Late-Start Days Increase Total Operative Time in Microvascular Breast Reconstruction

AU - Chu, Michael W.

AU - Barr, Jason S.

AU - Hill, J. Bradford

AU - Weichman, Katie E.

AU - Karp, Nolan S.

AU - Levine, Jamie P.

PY - 2015/2/4

Y1 - 2015/2/4

N2 - Background Prolonged operative time has been associated with increased postoperative complications and higher costs. Many academic centers have a designated day for didactics that cause cases to start 1 hour later. The purpose of this study is to analyze the late-start effect of microvascular breast reconstructions on operative duration. Methods A retrospective review was performed on all patients who underwent abdomina-based free flap breast reconstruction from 2007 to 2011 and analyzed by those who had surgery on late-start versus normal-start days. Patient demographics, average operative time, postoperative complications, and individual surgeon effects were analyzed. A Student t-test was used to compare operative times with statistical significance set at p < 0.05. A multivariate regression analysis was performed to control for potential confounders. Results A total of 272 patients underwent 461 free flap breast reconstructions. Twenty-one cases were performed on late-start days and 251 cases were performed on normal-start days. Patient demographics and complications were not statistically different between the groups. The average operative time for all reconstructions was 434.3 minutes. The average operative times were significantly longer for late-start days, 517.6 versus 427.3 minutes (p = 0.002). This was true for both unilateral and bilateral reconstructions (432.8 vs. 350.9 minutes, p = 0.05; 551.5 vs. 461.2 minutes, p = 0.007). There were no differences in perioperative complications and multivariate regression showed no statistically significant relationship of confounders to duration of surgery. Conclusion Starting cases 1 hour later can increase operative times. Although outcomes were not affected, we recommend avoiding lengthy procedures on late-start days.

AB - Background Prolonged operative time has been associated with increased postoperative complications and higher costs. Many academic centers have a designated day for didactics that cause cases to start 1 hour later. The purpose of this study is to analyze the late-start effect of microvascular breast reconstructions on operative duration. Methods A retrospective review was performed on all patients who underwent abdomina-based free flap breast reconstruction from 2007 to 2011 and analyzed by those who had surgery on late-start versus normal-start days. Patient demographics, average operative time, postoperative complications, and individual surgeon effects were analyzed. A Student t-test was used to compare operative times with statistical significance set at p < 0.05. A multivariate regression analysis was performed to control for potential confounders. Results A total of 272 patients underwent 461 free flap breast reconstructions. Twenty-one cases were performed on late-start days and 251 cases were performed on normal-start days. Patient demographics and complications were not statistically different between the groups. The average operative time for all reconstructions was 434.3 minutes. The average operative times were significantly longer for late-start days, 517.6 versus 427.3 minutes (p = 0.002). This was true for both unilateral and bilateral reconstructions (432.8 vs. 350.9 minutes, p = 0.05; 551.5 vs. 461.2 minutes, p = 0.007). There were no differences in perioperative complications and multivariate regression showed no statistically significant relationship of confounders to duration of surgery. Conclusion Starting cases 1 hour later can increase operative times. Although outcomes were not affected, we recommend avoiding lengthy procedures on late-start days.

KW - autologous breast reconstruction

KW - breast reconstruction

KW - free flap

KW - free tissue transfer

KW - late-start

KW - microvascular

KW - operative duration

KW - operative time

KW - OR time

UR - http://www.scopus.com/inward/record.url?scp=84931954994&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84931954994&partnerID=8YFLogxK

U2 - 10.1055/s-0035-1548740

DO - 10.1055/s-0035-1548740

M3 - Article

C2 - 25826441

AN - SCOPUS:84931954994

VL - 31

SP - 401

EP - 406

JO - Journal of Reconstructive Microsurgery

JF - Journal of Reconstructive Microsurgery

SN - 0743-684X

IS - 6

ER -