LAUSR

The demand placed on the National Health Service by Covid-19 has led to increased delays on elective surgery. Despite these challenges, our unit was the first centre in the UK to recommence elective breast reconstruction following the development of an evidence-based pathway to select low-risk patients. An enhanced recovery protocol was introduced to reduce length of stay. The aim of this study was to compare post-operative outcomes between our Pre-Covid group and our Covid-group of free tissue transfer breast reconstruction. We retrospectively reviewed autologous free tissue transfer breast reconstruction within our department between January 15th and September 27th 2020. Comparative data was split into two groups. A ‘pre-Covid group’ from 15th January to 12th March 2020 and a ‘Covid group’ from 3rd June to 27th September 2020. Both groups contained 15 patients. Operative notes and case notes were reviewed. Length of stay, haematoma-rate, flap failure, infection, fat necrosis, ischaemic time, re-do anastomosis and return-to-theatre were compared. Average length of stay was reduced from 4 to 3 days amongst our Covid group, haematoma rate was 7% pre-Covid and 13% during Covid. There was no evidence of flap failure, fat necrosis and donor site dehiscence in either group. Infection and flap dehiscence were 7% pre-Covid and 0% during Covid. Re-do anastomosis was 20% pre-Covid and 7% during Covid. No statistically significant changes in outcomes were identified. This early review suggests that elective breast reconstructive surgery can still be achieved with comparable outcomes, despite the added challenges of Covid-19.