Can Surgeons Choose Breast Implants in Advance? An Audit of Implant use in a busy Breast Unit
Association of Breast Surgery ePoster Library. Vijaysurej K. 05/15/17; 166283; P100
Dr. Kerrin Vijaysurej
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Abstract
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Introduction
At Maidstone and Tunbridge Wells NHS Trust (MTW), breast prostheses are ordered for individual patients in advance of the procedure. A bank of frequently used implants is also maintained in Maidstone Main Theatre Complex. We aimed to investigate whether the pre-ordered implants were used in the scheduled operation.
Methods
Retrospective data was collected on patients who had a breast implant procedure in Maidstone Hospital between January and December 2015. Information was retrieved from the MTW Breast Unit implant request forms and Maidstone Theatres Implant Registry and operative ledger.
Results
A total of 130 patients were identified and 97 had complete data. Four experienced consultant breast surgeons pre-ordered the implants and performed the operations. Of the 97 patients, 53 had primary reconstructions, 10 had primary reconstructions and contralateral augmentation, 25 had revision surgery, 8 had second stage implant exchange and 1 had a salvage procedure. The mean number of implants pre-ordered for a unilateral procedure was 4.16. In total, implants were correctly pre-ordered for 56 (58%) patients but in 41 (42%) cases, bank stock implants were used. The pre-ordering accuracy of the 4 surgeons ranged from 50-75%.
Conclusion
For units regularly undertaking implant reconstructions, it may be more efficient to maintain a comprehensive bank stock of breast prostheses as pre-ordering has limited accuracy. The process of ordering and returning implants also increases the workload on theatre staff and may have a financial penalty. Intraoperative sizing appears to be important and revision surgery makes up a significant proportion of implant-based procedures.
At Maidstone and Tunbridge Wells NHS Trust (MTW), breast prostheses are ordered for individual patients in advance of the procedure. A bank of frequently used implants is also maintained in Maidstone Main Theatre Complex. We aimed to investigate whether the pre-ordered implants were used in the scheduled operation.
Methods
Retrospective data was collected on patients who had a breast implant procedure in Maidstone Hospital between January and December 2015. Information was retrieved from the MTW Breast Unit implant request forms and Maidstone Theatres Implant Registry and operative ledger.
Results
A total of 130 patients were identified and 97 had complete data. Four experienced consultant breast surgeons pre-ordered the implants and performed the operations. Of the 97 patients, 53 had primary reconstructions, 10 had primary reconstructions and contralateral augmentation, 25 had revision surgery, 8 had second stage implant exchange and 1 had a salvage procedure. The mean number of implants pre-ordered for a unilateral procedure was 4.16. In total, implants were correctly pre-ordered for 56 (58%) patients but in 41 (42%) cases, bank stock implants were used. The pre-ordering accuracy of the 4 surgeons ranged from 50-75%.
Conclusion
For units regularly undertaking implant reconstructions, it may be more efficient to maintain a comprehensive bank stock of breast prostheses as pre-ordering has limited accuracy. The process of ordering and returning implants also increases the workload on theatre staff and may have a financial penalty. Intraoperative sizing appears to be important and revision surgery makes up a significant proportion of implant-based procedures.
Introduction
At Maidstone and Tunbridge Wells NHS Trust (MTW), breast prostheses are ordered for individual patients in advance of the procedure. A bank of frequently used implants is also maintained in Maidstone Main Theatre Complex. We aimed to investigate whether the pre-ordered implants were used in the scheduled operation.
Methods
Retrospective data was collected on patients who had a breast implant procedure in Maidstone Hospital between January and December 2015. Information was retrieved from the MTW Breast Unit implant request forms and Maidstone Theatres Implant Registry and operative ledger.
Results
A total of 130 patients were identified and 97 had complete data. Four experienced consultant breast surgeons pre-ordered the implants and performed the operations. Of the 97 patients, 53 had primary reconstructions, 10 had primary reconstructions and contralateral augmentation, 25 had revision surgery, 8 had second stage implant exchange and 1 had a salvage procedure. The mean number of implants pre-ordered for a unilateral procedure was 4.16. In total, implants were correctly pre-ordered for 56 (58%) patients but in 41 (42%) cases, bank stock implants were used. The pre-ordering accuracy of the 4 surgeons ranged from 50-75%.
Conclusion
For units regularly undertaking implant reconstructions, it may be more efficient to maintain a comprehensive bank stock of breast prostheses as pre-ordering has limited accuracy. The process of ordering and returning implants also increases the workload on theatre staff and may have a financial penalty. Intraoperative sizing appears to be important and revision surgery makes up a significant proportion of implant-based procedures.
At Maidstone and Tunbridge Wells NHS Trust (MTW), breast prostheses are ordered for individual patients in advance of the procedure. A bank of frequently used implants is also maintained in Maidstone Main Theatre Complex. We aimed to investigate whether the pre-ordered implants were used in the scheduled operation.
Methods
Retrospective data was collected on patients who had a breast implant procedure in Maidstone Hospital between January and December 2015. Information was retrieved from the MTW Breast Unit implant request forms and Maidstone Theatres Implant Registry and operative ledger.
Results
A total of 130 patients were identified and 97 had complete data. Four experienced consultant breast surgeons pre-ordered the implants and performed the operations. Of the 97 patients, 53 had primary reconstructions, 10 had primary reconstructions and contralateral augmentation, 25 had revision surgery, 8 had second stage implant exchange and 1 had a salvage procedure. The mean number of implants pre-ordered for a unilateral procedure was 4.16. In total, implants were correctly pre-ordered for 56 (58%) patients but in 41 (42%) cases, bank stock implants were used. The pre-ordering accuracy of the 4 surgeons ranged from 50-75%.
Conclusion
For units regularly undertaking implant reconstructions, it may be more efficient to maintain a comprehensive bank stock of breast prostheses as pre-ordering has limited accuracy. The process of ordering and returning implants also increases the workload on theatre staff and may have a financial penalty. Intraoperative sizing appears to be important and revision surgery makes up a significant proportion of implant-based procedures.
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