Cost analysis of near-infrared spectroscopy tissue oximetry for monitoring autologous free tissue breast reconstruction

Aaron Pelletier, Charles Tseng, Shailesh Agarwal, Julie Park, David Song

Research output: Contribution to journalReview article

27 Citations (Scopus)

Abstract

Free flap monitoring typically requires specialized nursing that can increase medical costs. This study uses near-infrared spectroscopy (NIRS) tissue oximetry to monitor free tissue breast reconstruction. We hypothesize this practice will reduce medical costs by eliminating the need for specialized nursing. From August 2006 to January 2010, women undergoing unilateral free tissue breast reconstruction were enrolled and admitted postoperatively to either the surgical intensive care unit (ICU) or floor. Each underwent continuous monitoring using NIRS tissue oximetry and intermittent clinical examination with surface Doppler ultrasonography. Patient demographics, comorbidities, perioperative details, and financial data were recorded. There were 50 patients studied, all with abdominal-based flaps (25 per group). There were no statistically significant differences in patient demographics, comorbidities, mean flap weight, ischemia time, or length of stay between the ICU and floor groups. Four flaps had vascular complications, all detected by NIRS tissue oximetry. Comparison of hospital costs showed an average reduction of $1937 per patient when monitored on the surgical floor (p=0.036). NIRS tissue oximetry is a sensitive and reliable monitoring tool, eliminating the need for specialized nursing care. The effect is decreased cost structure and increased hospital contribution margin for autologous free tissue breast reconstruction.

Original languageEnglish (US)
Pages (from-to)487-493
Number of pages7
JournalJournal of Reconstructive Microsurgery
Volume27
Issue number8
DOIs
StatePublished - Jul 25 2011
Externally publishedYes

Fingerprint

Oximetry
Near-Infrared Spectroscopy
Mammaplasty
Costs and Cost Analysis
Intensive Care Units
Comorbidity
Nursing
Demography
Doppler Ultrasonography
Free Tissue Flaps
Hospital Costs
Critical Care
Nursing Care
Blood Vessels
Length of Stay
Ischemia
Weights and Measures

Keywords

  • Breast reconstruction
  • free flap monitoring
  • near-infrared spectroscopy tissue oximetry

ASJC Scopus subject areas

  • Surgery

Cite this

Cost analysis of near-infrared spectroscopy tissue oximetry for monitoring autologous free tissue breast reconstruction. / Pelletier, Aaron; Tseng, Charles; Agarwal, Shailesh; Park, Julie; Song, David.

In: Journal of Reconstructive Microsurgery, Vol. 27, No. 8, 25.07.2011, p. 487-493.

Research output: Contribution to journalReview article

Pelletier, Aaron ; Tseng, Charles ; Agarwal, Shailesh ; Park, Julie ; Song, David. / Cost analysis of near-infrared spectroscopy tissue oximetry for monitoring autologous free tissue breast reconstruction. In: Journal of Reconstructive Microsurgery. 2011 ; Vol. 27, No. 8. pp. 487-493.
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