An Update on the Safety and Efficacy of Outpatient Plastic Surgery: A Review of 26,032 Consecutive Cases

Rod J. Rohrich, Bernardino M. Mendez, Paul N. Afrooz

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Outpatient surgery offers many advantages, including cost-containment, privacy, and convenience. However, patient safety must take precedence over these benefits. Limited well-designed studies exist in the plastic surgery literature on patient safety in the outpatient setting, particularly those that identify risk factors for adverse outcomes.

METHODS: A retrospective review was performed on 26,032 consecutive cases completed by board-certified plastic surgeons at an accredited outpatient surgical center between 1995 and 2017. All cases were reviewed for potential morbidity and mortality events, and variables were analyzed to determine potential risk factors for postoperative complications and inpatient admission.

RESULTS: A total of 26,032 cases were performed over a 23-year period. There were a total of 203 complications (0.78 percent). Compared with the control population, the 12 patients (0.05 percent) that sustained venous thromboembolic events demonstrated higher body mass indexes (p < 0.01), greater lipoaspirate amounts (p = 0.04), longer operative times (p < 0.01), and were more likely to have undergone a combined procedure (p < 0.01). In addition, the 22 patients (0.08 percent) that were transferred to inpatient facilities demonstrated greater body mass index (p < 0.01) and longer operative times (p = 0.01).

CONCLUSIONS: Plastic surgery is safe to perform in an accredited outpatient facility for a majority of patients. According to the authors' data, postoperative monitoring in a nursing facility should be considered for the following high-risk patients: those with a body mass index greater than 30 kg/m, operative times greater than 4 hours, lipoaspirate volumes greater than 3 liters, and those undergoing combined procedures.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

Original languageEnglish (US)
Pages (from-to)902-908
Number of pages7
JournalPlastic and Reconstructive Surgery
Volume141
Issue number4
DOIs
StatePublished - Apr 1 2018

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Plastic Surgery
Ambulatory Surgical Procedures
Operative Time
Safety
Body Mass Index
Outpatients
Patient Safety
Inpatients
Cost Control
Privacy
Nursing
Morbidity
Mortality
Population

ASJC Scopus subject areas

  • Surgery

Cite this

An Update on the Safety and Efficacy of Outpatient Plastic Surgery : A Review of 26,032 Consecutive Cases. / Rohrich, Rod J.; Mendez, Bernardino M.; Afrooz, Paul N.

In: Plastic and Reconstructive Surgery, Vol. 141, No. 4, 01.04.2018, p. 902-908.

Research output: Contribution to journalArticle

Rohrich, Rod J. ; Mendez, Bernardino M. ; Afrooz, Paul N. / An Update on the Safety and Efficacy of Outpatient Plastic Surgery : A Review of 26,032 Consecutive Cases. In: Plastic and Reconstructive Surgery. 2018 ; Vol. 141, No. 4. pp. 902-908.
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AB - BACKGROUND: Outpatient surgery offers many advantages, including cost-containment, privacy, and convenience. However, patient safety must take precedence over these benefits. Limited well-designed studies exist in the plastic surgery literature on patient safety in the outpatient setting, particularly those that identify risk factors for adverse outcomes.METHODS: A retrospective review was performed on 26,032 consecutive cases completed by board-certified plastic surgeons at an accredited outpatient surgical center between 1995 and 2017. All cases were reviewed for potential morbidity and mortality events, and variables were analyzed to determine potential risk factors for postoperative complications and inpatient admission.RESULTS: A total of 26,032 cases were performed over a 23-year period. There were a total of 203 complications (0.78 percent). Compared with the control population, the 12 patients (0.05 percent) that sustained venous thromboembolic events demonstrated higher body mass indexes (p < 0.01), greater lipoaspirate amounts (p = 0.04), longer operative times (p < 0.01), and were more likely to have undergone a combined procedure (p < 0.01). In addition, the 22 patients (0.08 percent) that were transferred to inpatient facilities demonstrated greater body mass index (p < 0.01) and longer operative times (p = 0.01).CONCLUSIONS: Plastic surgery is safe to perform in an accredited outpatient facility for a majority of patients. According to the authors' data, postoperative monitoring in a nursing facility should be considered for the following high-risk patients: those with a body mass index greater than 30 kg/m, operative times greater than 4 hours, lipoaspirate volumes greater than 3 liters, and those undergoing combined procedures.CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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