Textbook outcomes in DIEP flap breast reconstruction: a Delphi study to establish consensus.
Research article published in Breast cancer research and treatment (2022)
Abstract
PURPOSE: Composite measures, like textbook outcomes, may be superior to individual metrics when assessing hospital performance and quality of care. This study utilized a Delphi process to define a textbook outcome in DIEP flap breast reconstruction. METHODS: A two-round Delphi survey defined: (1) A textbook outcome, (2) Exclusion criteria for a study population, and (3) Respondent opinion regarding textbook outcomes. An a priori threshold of ≥ 70% agreement among respondents established consensus among the tested statements. RESULTS: Out of 85 invitees, 48 responded in the first round and 41 in the second. A textbook outcome was defined as one that meets the following within 90 days: (1) No intraoperative complications, (2) Operative duration ≤ 12 h for bilateral and ≤ 10 h for unilateral/stacked reconstruction, (3) No post-surgical complications requiring re-operation, (4) No surgical site infection requiring IV antibiotics, (5) No readmission, (6) No mortality, (7) No systemic complications, and (8) Length of stay < 5 days. Exclusion criteria for medical and surgical characteristics (e.g., BMI > 40, HgbA1c > 7) and case-volume cut-offs for providers (≥ 21) and institutions (≥ 44) were defined. Most agreed that textbook outcomes should be defined for complex plastic surgery procedures (75%) and utilized to gauge hospital performance for microsurgical breast reconstruction (77%). CONCLUSION: This Delphi study identified (1) Key elements of a textbook outcome for DIEP flap breast reconstruction, (2) Exclusion criteria for future studies, and (3) Characterized surgeon opinions regarding the utility of textbook outcomes in serving as quality metric for breast reconstruction care.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Composite measures, like textbook outcomes, may be superior to individual metrics when assessing hospital performance and quality of care. This study utilized a Delphi process to define a textbook outcome in DIEP flap breast reconstruction.
Por qué esto importa para la hirudoterapia
Este estudio Delphi estableció una definición de consenso para un «resultado de libro de texto» en la reconstrucción mamaria con colgajo DIEP, que abarca criterios como la ausencia de complicaciones intraoperatorias, la ausencia de infecciones del sitio quirúrgico y la ausencia de complicaciones posquirúrgicas que requieran reintervención. El estudio define métricas de calidad y criterios de exclusión para evaluar el desempeño hospitalario y el éxito quirúrgico en procedimientos microquirúrgicos mamarios complejos. El resumen se centra exclusivamente en estas definiciones de referencia quirúrgicas y no menciona complicaciones específicas del colgajo posoperatorio, congestión venosa ni terapias de rescate. En consecuencia, el artículo no hace referencia a las sanguijuelas, la hirudoterapia ni al secretoma de la sanguijuela, lo que hace que su relevancia para la American Society of Hirudotherapy sea completamente inexistente.
Citación
Textbook outcomes in DIEP flap breast reconstruction: a Delphi study to establish consensus.
Shammas et al. · Breast cancer research and treatment, 2022
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026