Standardizing the complication rate after breast reduction using the Clavien-Dindo classification

Raimund Winter, Isabella Haug, Patricia Lebo, Martin Grohmann, Frederike M J Reischies, Janos Cambiaso-Daniel, Alexandru Tuca, Theresa Rienmüller, Herwig Friedl, Stephan Spendel, Abigail A. Forbes, Paul Wurzer, Lars P. Kamolz

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Published complication rates for breast reduction surgery, also known as reduction mammaplasty, vary between 4% and 54%. This wide range of complication rates could be attributable to the lack of a standardized classification of complications in plastic surgery. The aim of this study was to analyze our single-center complication rates after reduction mammaplasty using the Clavien-Dindo classification. Methods: We performed a retrospective chart review studying 804 patients between the ages of 18 and 81 years old who underwent breast reduction between 2005 and 2015 at our institution. Patients with a history of breast cancer, a previous breast operation, who did not undergo bilateral reduction mammaplasty, or who required systemic immunodeficiency/immunosuppressive drugs were excluded from our analysis. Complications were classified according to the Clavien-Dindo classification from Grades I to V. Results: A total of 486 patients met the inclusion criteria for the analysis. Patients had an age (mean ± standard deviation) of 39 ± 13 years and a body mass index of 26 ± 4 kg/m2. Median follow-up was 274 days (interquartile range: 90.5-378). The overall rate of complications of reduction mammaplasty was 63%, with the majority of those being Grades I (48%) and II (9%), comprising 92% of all the complications. Operative revisions were required in 6% (1% Grade IIIA and 5% Grade IIIB). There were no complications graded in categories IV and V. Conclusion: Although complications occurred in more than half of the cases, the majority did not require operative reintervention. The Clavien-Dindo classification can classify the severity of complications and serve as a benchmark to compare complication rates between different practices. We believe that grading of complications should distinguish between those that do and do not require operative reinterventions.

Original languageEnglish (US)
JournalSurgery (United States)
DOIs
StateAccepted/In press - 2016
Externally publishedYes

Fingerprint

Mammaplasty
Breast
Benchmarking
Plastic Surgery
Immunosuppressive Agents
Body Mass Index
Breast Neoplasms
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Surgery

Cite this

Winter, R., Haug, I., Lebo, P., Grohmann, M., Reischies, F. M. J., Cambiaso-Daniel, J., ... Kamolz, L. P. (Accepted/In press). Standardizing the complication rate after breast reduction using the Clavien-Dindo classification. Surgery (United States). https://doi.org/10.1016/j.surg.2016.11.028

Standardizing the complication rate after breast reduction using the Clavien-Dindo classification. / Winter, Raimund; Haug, Isabella; Lebo, Patricia; Grohmann, Martin; Reischies, Frederike M J; Cambiaso-Daniel, Janos; Tuca, Alexandru; Rienmüller, Theresa; Friedl, Herwig; Spendel, Stephan; Forbes, Abigail A.; Wurzer, Paul; Kamolz, Lars P.

In: Surgery (United States), 2016.

Research output: Contribution to journalArticle

Winter, R, Haug, I, Lebo, P, Grohmann, M, Reischies, FMJ, Cambiaso-Daniel, J, Tuca, A, Rienmüller, T, Friedl, H, Spendel, S, Forbes, AA, Wurzer, P & Kamolz, LP 2016, 'Standardizing the complication rate after breast reduction using the Clavien-Dindo classification', Surgery (United States). https://doi.org/10.1016/j.surg.2016.11.028
Winter, Raimund ; Haug, Isabella ; Lebo, Patricia ; Grohmann, Martin ; Reischies, Frederike M J ; Cambiaso-Daniel, Janos ; Tuca, Alexandru ; Rienmüller, Theresa ; Friedl, Herwig ; Spendel, Stephan ; Forbes, Abigail A. ; Wurzer, Paul ; Kamolz, Lars P. / Standardizing the complication rate after breast reduction using the Clavien-Dindo classification. In: Surgery (United States). 2016.
@article{0f34ec0cf3ad43188a2e77750a7d2712,
title = "Standardizing the complication rate after breast reduction using the Clavien-Dindo classification",
abstract = "Background: Published complication rates for breast reduction surgery, also known as reduction mammaplasty, vary between 4{\%} and 54{\%}. This wide range of complication rates could be attributable to the lack of a standardized classification of complications in plastic surgery. The aim of this study was to analyze our single-center complication rates after reduction mammaplasty using the Clavien-Dindo classification. Methods: We performed a retrospective chart review studying 804 patients between the ages of 18 and 81 years old who underwent breast reduction between 2005 and 2015 at our institution. Patients with a history of breast cancer, a previous breast operation, who did not undergo bilateral reduction mammaplasty, or who required systemic immunodeficiency/immunosuppressive drugs were excluded from our analysis. Complications were classified according to the Clavien-Dindo classification from Grades I to V. Results: A total of 486 patients met the inclusion criteria for the analysis. Patients had an age (mean ± standard deviation) of 39 ± 13 years and a body mass index of 26 ± 4 kg/m2. Median follow-up was 274 days (interquartile range: 90.5-378). The overall rate of complications of reduction mammaplasty was 63{\%}, with the majority of those being Grades I (48{\%}) and II (9{\%}), comprising 92{\%} of all the complications. Operative revisions were required in 6{\%} (1{\%} Grade IIIA and 5{\%} Grade IIIB). There were no complications graded in categories IV and V. Conclusion: Although complications occurred in more than half of the cases, the majority did not require operative reintervention. The Clavien-Dindo classification can classify the severity of complications and serve as a benchmark to compare complication rates between different practices. We believe that grading of complications should distinguish between those that do and do not require operative reinterventions.",
author = "Raimund Winter and Isabella Haug and Patricia Lebo and Martin Grohmann and Reischies, {Frederike M J} and Janos Cambiaso-Daniel and Alexandru Tuca and Theresa Rienm{\"u}ller and Herwig Friedl and Stephan Spendel and Forbes, {Abigail A.} and Paul Wurzer and Kamolz, {Lars P.}",
year = "2016",
doi = "10.1016/j.surg.2016.11.028",
language = "English (US)",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Standardizing the complication rate after breast reduction using the Clavien-Dindo classification

AU - Winter, Raimund

AU - Haug, Isabella

AU - Lebo, Patricia

AU - Grohmann, Martin

AU - Reischies, Frederike M J

AU - Cambiaso-Daniel, Janos

AU - Tuca, Alexandru

AU - Rienmüller, Theresa

AU - Friedl, Herwig

AU - Spendel, Stephan

AU - Forbes, Abigail A.

AU - Wurzer, Paul

AU - Kamolz, Lars P.

PY - 2016

Y1 - 2016

N2 - Background: Published complication rates for breast reduction surgery, also known as reduction mammaplasty, vary between 4% and 54%. This wide range of complication rates could be attributable to the lack of a standardized classification of complications in plastic surgery. The aim of this study was to analyze our single-center complication rates after reduction mammaplasty using the Clavien-Dindo classification. Methods: We performed a retrospective chart review studying 804 patients between the ages of 18 and 81 years old who underwent breast reduction between 2005 and 2015 at our institution. Patients with a history of breast cancer, a previous breast operation, who did not undergo bilateral reduction mammaplasty, or who required systemic immunodeficiency/immunosuppressive drugs were excluded from our analysis. Complications were classified according to the Clavien-Dindo classification from Grades I to V. Results: A total of 486 patients met the inclusion criteria for the analysis. Patients had an age (mean ± standard deviation) of 39 ± 13 years and a body mass index of 26 ± 4 kg/m2. Median follow-up was 274 days (interquartile range: 90.5-378). The overall rate of complications of reduction mammaplasty was 63%, with the majority of those being Grades I (48%) and II (9%), comprising 92% of all the complications. Operative revisions were required in 6% (1% Grade IIIA and 5% Grade IIIB). There were no complications graded in categories IV and V. Conclusion: Although complications occurred in more than half of the cases, the majority did not require operative reintervention. The Clavien-Dindo classification can classify the severity of complications and serve as a benchmark to compare complication rates between different practices. We believe that grading of complications should distinguish between those that do and do not require operative reinterventions.

AB - Background: Published complication rates for breast reduction surgery, also known as reduction mammaplasty, vary between 4% and 54%. This wide range of complication rates could be attributable to the lack of a standardized classification of complications in plastic surgery. The aim of this study was to analyze our single-center complication rates after reduction mammaplasty using the Clavien-Dindo classification. Methods: We performed a retrospective chart review studying 804 patients between the ages of 18 and 81 years old who underwent breast reduction between 2005 and 2015 at our institution. Patients with a history of breast cancer, a previous breast operation, who did not undergo bilateral reduction mammaplasty, or who required systemic immunodeficiency/immunosuppressive drugs were excluded from our analysis. Complications were classified according to the Clavien-Dindo classification from Grades I to V. Results: A total of 486 patients met the inclusion criteria for the analysis. Patients had an age (mean ± standard deviation) of 39 ± 13 years and a body mass index of 26 ± 4 kg/m2. Median follow-up was 274 days (interquartile range: 90.5-378). The overall rate of complications of reduction mammaplasty was 63%, with the majority of those being Grades I (48%) and II (9%), comprising 92% of all the complications. Operative revisions were required in 6% (1% Grade IIIA and 5% Grade IIIB). There were no complications graded in categories IV and V. Conclusion: Although complications occurred in more than half of the cases, the majority did not require operative reintervention. The Clavien-Dindo classification can classify the severity of complications and serve as a benchmark to compare complication rates between different practices. We believe that grading of complications should distinguish between those that do and do not require operative reinterventions.

UR - http://www.scopus.com/inward/record.url?scp=85009461358&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85009461358&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2016.11.028

DO - 10.1016/j.surg.2016.11.028

M3 - Article

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

ER -