Prevention of perioperative limb XXXX in abdominal free flap breast reconstruction.

@entity1 @entity1897 @entity16
BACKGROUND AND AIMS: Perioperative @entity1897 are a significant cause of post-operative morbidity in @entity1 undergoing prolonged procedures. The aims of this study were to determine the incidence and possible causes of @entity1897 in @entity1 undergoing abdominal free flap breast reconstruction and to develop methods of ameliorating this problem. METHODS: A 4-year retrospective study of @entity1 undergoing abdominal free flap breast reconstruction by a single surgeon and anaesthetist was undertaken to determine the incidence and potential causes of perioperative @entity16 . A new positioning protocol was introduced to minimise the stretch on the brachial plexus and to protect peripheral nerves from compression forces. In addition, regular intraoperative physiotherapy was introduced. A prospective study was then conducted on @entity1 managed by the same team to evaluate the effect of this change in practice on the subsequent incidence of @entity1897 . RESULTS: Over the 4-year retrospective period, 93 consecutive @entity1 underwent abdominal free flap breast reconstruction, six of whom (6.5%) developed a @entity1897 . Following the introduction of the new positioning protocol, prospective data collected on 65 consecutive @entity1 showed no further occurrences of perioperative @entity16 (p  =  0.04). There were no significant differences in the characteristics between the two cohorts. CONCLUSION: Perioperative @entity1897 in abdominal free flap breast reconstruction is a preventable problem. This paper presents a @entity1897 prevention protocol for managing these @entity1 .
