The introduction of a breast implant surgical checklist reduces implant loss rate
Association of Breast Surgery ePoster Library. Meadows S. 05/13/19; 257157; P114
Mr. Sam Meadows
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P114
Topic: Oncoplastic and aesthetic surgery
Introduction:Implant based reconstruction accounts for around 40% of immediate breast reconstructions nationally. Implant loss impacts patients emotionally, physically and can delay adjuvant treatment. National Mastectomy Breast Reconstruction Audit reports implant losses of 9% in immediate reconstruction at 3 months. ABS/BAPRAS guidelines have targets set at <5%.Our institution noticed increases in implant loss due to infection between 2016-2017, with significant variation in practice between surgeons. We aimed to identify causative factors, compare practice to national guidelines and develop strategies to minimise losses. Methods :We reviewed cases of implant loss between 1/1/16 - 31/9/17 using the trust's reconstruction database. We completed a root cause analysis to identify causative factors, and implemented a surgical checklist aimed at standardising practice and reducing contributing factors to implant loss. Results: Between 1/1/16 - 31/9/17, 116 primary implant reconstructions were performed. 19(16.4%) resulted in implant loss due to infection within 3 months. Root cause analysis demonstrated multifactorial aetiology - no causative link between adjuvant therapies, implant type, ADMs or patient factors were identified. No single pathological organism was identified. Following introduction of a surgical checklist, 42 primary implant reconstructions were performed. Only 3(7.1%) resulted in implant loss within 3 months. Implementation of a standardised surgical checklist therefore reduced implant loss from 16.4% to 7.1%. Conclusions:There is a high risk of implant loss following primary reconstruction. The aetiology is multifactorial; patient selection and standardised surgical technique is recommended for minimising losses. The introduction of a surgical checklist is one strategy aimed at achieving this.
Topic: Oncoplastic and aesthetic surgery
Introduction:Implant based reconstruction accounts for around 40% of immediate breast reconstructions nationally. Implant loss impacts patients emotionally, physically and can delay adjuvant treatment. National Mastectomy Breast Reconstruction Audit reports implant losses of 9% in immediate reconstruction at 3 months. ABS/BAPRAS guidelines have targets set at <5%.Our institution noticed increases in implant loss due to infection between 2016-2017, with significant variation in practice between surgeons. We aimed to identify causative factors, compare practice to national guidelines and develop strategies to minimise losses. Methods :We reviewed cases of implant loss between 1/1/16 - 31/9/17 using the trust's reconstruction database. We completed a root cause analysis to identify causative factors, and implemented a surgical checklist aimed at standardising practice and reducing contributing factors to implant loss. Results: Between 1/1/16 - 31/9/17, 116 primary implant reconstructions were performed. 19(16.4%) resulted in implant loss due to infection within 3 months. Root cause analysis demonstrated multifactorial aetiology - no causative link between adjuvant therapies, implant type, ADMs or patient factors were identified. No single pathological organism was identified. Following introduction of a surgical checklist, 42 primary implant reconstructions were performed. Only 3(7.1%) resulted in implant loss within 3 months. Implementation of a standardised surgical checklist therefore reduced implant loss from 16.4% to 7.1%. Conclusions:There is a high risk of implant loss following primary reconstruction. The aetiology is multifactorial; patient selection and standardised surgical technique is recommended for minimising losses. The introduction of a surgical checklist is one strategy aimed at achieving this.
P114
Topic: Oncoplastic and aesthetic surgery
Introduction:Implant based reconstruction accounts for around 40% of immediate breast reconstructions nationally. Implant loss impacts patients emotionally, physically and can delay adjuvant treatment. National Mastectomy Breast Reconstruction Audit reports implant losses of 9% in immediate reconstruction at 3 months. ABS/BAPRAS guidelines have targets set at <5%.Our institution noticed increases in implant loss due to infection between 2016-2017, with significant variation in practice between surgeons. We aimed to identify causative factors, compare practice to national guidelines and develop strategies to minimise losses. Methods :We reviewed cases of implant loss between 1/1/16 - 31/9/17 using the trust's reconstruction database. We completed a root cause analysis to identify causative factors, and implemented a surgical checklist aimed at standardising practice and reducing contributing factors to implant loss. Results: Between 1/1/16 - 31/9/17, 116 primary implant reconstructions were performed. 19(16.4%) resulted in implant loss due to infection within 3 months. Root cause analysis demonstrated multifactorial aetiology - no causative link between adjuvant therapies, implant type, ADMs or patient factors were identified. No single pathological organism was identified. Following introduction of a surgical checklist, 42 primary implant reconstructions were performed. Only 3(7.1%) resulted in implant loss within 3 months. Implementation of a standardised surgical checklist therefore reduced implant loss from 16.4% to 7.1%. Conclusions:There is a high risk of implant loss following primary reconstruction. The aetiology is multifactorial; patient selection and standardised surgical technique is recommended for minimising losses. The introduction of a surgical checklist is one strategy aimed at achieving this.
Topic: Oncoplastic and aesthetic surgery
Introduction:Implant based reconstruction accounts for around 40% of immediate breast reconstructions nationally. Implant loss impacts patients emotionally, physically and can delay adjuvant treatment. National Mastectomy Breast Reconstruction Audit reports implant losses of 9% in immediate reconstruction at 3 months. ABS/BAPRAS guidelines have targets set at <5%.Our institution noticed increases in implant loss due to infection between 2016-2017, with significant variation in practice between surgeons. We aimed to identify causative factors, compare practice to national guidelines and develop strategies to minimise losses. Methods :We reviewed cases of implant loss between 1/1/16 - 31/9/17 using the trust's reconstruction database. We completed a root cause analysis to identify causative factors, and implemented a surgical checklist aimed at standardising practice and reducing contributing factors to implant loss. Results: Between 1/1/16 - 31/9/17, 116 primary implant reconstructions were performed. 19(16.4%) resulted in implant loss due to infection within 3 months. Root cause analysis demonstrated multifactorial aetiology - no causative link between adjuvant therapies, implant type, ADMs or patient factors were identified. No single pathological organism was identified. Following introduction of a surgical checklist, 42 primary implant reconstructions were performed. Only 3(7.1%) resulted in implant loss within 3 months. Implementation of a standardised surgical checklist therefore reduced implant loss from 16.4% to 7.1%. Conclusions:There is a high risk of implant loss following primary reconstruction. The aetiology is multifactorial; patient selection and standardised surgical technique is recommended for minimising losses. The introduction of a surgical checklist is one strategy aimed at achieving this.
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