Complications Following Abdominal-Based Microsurgical Breast Reconstruction.
BACKGROUND Microsurgical breast reconstruction is the gold standard for patients after a mastectomy. Despite the benefits associated with microsurgical reconstruction, there remain considerable challenges at the level of both patient and health service. This study aimed to uncover variables associated with post-surgical complications following microsurgical autologous reconstruction in a single centre Australian cohort with the aim of informing future strategies to reduce risk and cost. METHODS We conducted a retrospective cohort analysis utilising data from the electronic medical records of a tertiary breast reconstruction service in Melbourne, Australia between August 2022 and February 2024. Data on post-surgical complications were collected, with a particular focus on respiratory and wound complications. RESULTS A total of 204 women, with a mean age of 49.8 years, were included. Multivariate logistic analysis found that for every kg/m2 point increase in BMI, respiratory complications increased by 8%. Respiratory comorbidities and operative duration were also associated with respiratory complications. For every kg/m2 point increase in BMI, wound complications increased by 11%. Respiratory comorbidities and intra-operative fluid volume were also associated with wound complications. CONCLUSIONS We identified several pre- and intra-operative risk factors that may assist in informing changes to standard clinical practice, in the hopes of optimising the overall experience for a patient undergoing microsurgical breast reconstruction. These quantified risks may also enable better patient education or institutional decisions to offer alternative pathways to high-risk patients.