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改善乳房重建患者体验:加速康复外科及其他

Improving the Patient Experience in Breast Reconstruction: ERAS and Beyond.

作者信息

Haas Evan J, Hamzeh Bilal F, Aryanpour Zain, Yu Jason W, Mathes David W, Kaoutzanis Christodoulos

机构信息

School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.

出版信息

J Clin Med. 2025 Aug 7;14(15):5595. doi: 10.3390/jcm14155595.

Abstract

: Breast reconstruction after mastectomy has been shown to significantly improve psychosocial wellbeing and quality of life. Enhanced Recovery After Surgery (ERAS) protocols, especially those tailored to breast reconstruction, have revolutionized recovery by reducing complications, pain, opioid use, and hospital stay while improving patient satisfaction. The purpose of this narrative review was to present existing practices and supporting evidence within current ERAS protocols, as well as propose a modern ERAS framework centered around enhancing the patient experience following breast reconstruction. : A focused literature search was conducted to identify studies investigating emerging approaches to patient care and surgical techniques adopted as part of a broader ERAS workflow : Some recent innovations include digital ERAS tracking, robot-assisted techniques, neurotization, and closed incision negative pressure therapy (ciNPT). These innovations show promise in reducing morbidity following reconstruction and may greatly improve sensory and functional outcomes. These advancements also reflect a shift toward more holistic, patient-centered care, extending beyond immediate clinical needs to address long-term wellbeing through psychosocial support and patient-reported outcome measures. Incorporating tools that validate patient perspectives helps guide interventions to optimize satisfaction and recovery. : Future research should aim to standardize ERAS protocols by incorporating evidence-based practices, reinforcing breast reconstruction as a patient-centered, evidence-driven process that is focused on comprehensive recovery and improved quality of life.

摘要

乳房切除术后的乳房重建已被证明能显著改善心理社会幸福感和生活质量。术后加速康复(ERAS)方案,尤其是那些针对乳房重建量身定制的方案,通过减少并发症、疼痛、阿片类药物使用和住院时间,同时提高患者满意度,彻底改变了康复过程。本叙述性综述的目的是介绍当前ERAS方案中的现有做法和支持证据,并提出一个以增强乳房重建后患者体验为中心的现代ERAS框架。:进行了一项针对性的文献检索,以确定调查作为更广泛ERAS工作流程一部分所采用的新兴患者护理方法和手术技术的研究:一些近期的创新包括数字化ERAS跟踪、机器人辅助技术、神经移植和闭合切口负压治疗(ciNPT)。这些创新在降低重建后的发病率方面显示出前景,并可能极大地改善感觉和功能结果。这些进展还反映了向更全面、以患者为中心的护理的转变,超越了即时临床需求,通过心理社会支持和患者报告的结果测量来解决长期幸福感问题。纳入验证患者观点的工具有助于指导干预措施,以优化满意度和康复效果。:未来的研究应旨在通过纳入循证实践来规范ERAS方案,强化乳房重建是以患者为中心、循证驱动的过程,该过程侧重于全面康复和改善生活质量。

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