Perioperative management of direct-to-implant-based breast reconstruction in breast cancer patients and West China Hospital experiences.
10.7507/1002-1892.202505006
- Author:
Yu FENG
1
;
Donglin ZHANG
2
;
Faqing LIANG
1
;
Guilin LUO
2
;
Zhenggui DU
1
Author Information
1. Department of General Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
2. Department of General Surgery, the Fourth People's Hospital of Sichuan Province (West China Chun Xi Hospital), Chengdu Sichuan, 610016, P. R. China.
- Publication Type:English Abstract
- Keywords:
Breast cancer;
direct-to-implant-based breast reconstruction;
perioperative management
- MeSH:
Humans;
Female;
Breast Neoplasms/surgery*;
China;
Perioperative Care/methods*;
Breast Implants;
Mammaplasty/methods*;
Breast Implantation/methods*;
Postoperative Complications/prevention & control*;
Quality of Life;
Mastectomy
- From:
Chinese Journal of Reparative and Reconstructive Surgery
2025;39(10):1356-1362
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To optimize the perioperative management experiences for breast cancer patients undergoing direct-to-implant-based breast reconstruction, and provide reference for clinical practice.
METHODS:A comprehensive review of recent domestic and international literature was conducted to systematically summarize the key points of perioperative management for direct-to-implant-based breast reconstruction, including preoperative health education, intraoperative strategies, and postoperative management measures, along with an introduction to the clinical experiences of West China Hospital of Sichuan University.
RESULTS:Standardized perioperative management can effectively reduce the incidence of complications and achieve excellent cosmetic outcomes and quality of life after operation. Preoperative management includes proactive health education to alleviate patients' anxiety and improve treatment compliance, as well as comprehensive assessment by surgeons of the patient's physical condition and reconstructive expectations to select the most appropriate implant. Intraoperative management consists of strict aseptic technique, minimizing implant exposure, preserving blood supply to the nipple-areola complex (e.g., by using minimally invasive techniques or indocyanine green angiography, etc), and meticulous hemostasis. Postoperative management encompasses multimodal analgesia, individualized drain management (such as early removal or retaining a small amount of fluid to optimize contour), infection prevention and control (including topical and systemic antibiotics, ultrasound-guided minimally invasive drainage), guidance on rehabilitation exercises (early activity restriction followed by gradual recovery), and regular follow-up to evaluate aesthetic results and monitor for complications.
CONCLUSION:Establishing a standardized, multidisciplinary perioperative management framework markedly enhances surgical safety and patient satisfaction, thereby providing a replicable benchmark for direct-to-implant-based breast reconstruction across diverse clinical settings.
