Enhanced recovery after surgery (ERAS) is an important concept in today’s accountancy dominated hospitals, effectively decreasing the length of stay (LOS) of postoperative patients. This is something that surgeons will have to consider – or have protocols foisted upon them by non-medical administrators. The paper shows that when ERAS pathways were followed there was a significant reduction in the length of hospital stay - 3.9 days against 5.5 days for the traditional recovery after surgery (TRAS). There were increased complications in the ERAS group although these were not statistically significant. The details of the ERAS regime are spelled out comprehensively in the article, but those changes which are most noticeable from the TRAS regime are, firstly, that nobody is routinely sent to ICU, but a specialised nurse is employed to look after the postoperative patient. Also, there is every attempt made to avoid opiates and also to avoid IV fluids. Very early mobilisation and oral feeding is instigated. Those surgeons, nurses (and administrators) who are interested in shortening their patients’ hospitalisation should read this paper!
ERAS in microvascular breast reconstruction
Reviewed by Martyn Webster
Enhanced recovery after surgery in microvascular breast reconstruction.
