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Can SPY Elite be a cost effective instrument in plastic surgery?
Snyder, S., Maslowski, D., Summers, J., Ueno C.M.
West Virginia University
2019-02-15
Presenter: Doug Maslowski
Affidavit:
I certify that this material has not been published in any scientific journal or presented at any major meetings. The paper was written by Sean Snyder and Doug Maslowski. I provided the edits.
Director Name: Dr. Cristiane Ueno
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
The SPY Near-Infrared Perfusion Assessment System has been validated in many studies and its use is growing across the country. It can be used in many surgeries including breast reconstruction. The SPY system was purchased by WVU hospitals in 2017 to improve outcomes in plastic surgery. WVU uses ACS-NSQIP to gauge the hospital performance based on outcomes. Literature shows the use of NSQIP improves surgical outcomes, decreases complications, improves care, and reduces total hospital related costs.
Date was compared from immediate breast reconstruction with tissue expanders from 2016-2017 (pre-SPY) to 2017-2018 (post SPY). Outcomes involved length of stay, surgical site infection (SSI), 30-day readmission, return to OR, and wound dehiscence. The post SPY numbers were improved for all quality metrics compared to pre-SPY and demonstrated impressive improvements in the WVU Hospital's numbers when compared to the NSQIP standards. Specific improvements with implementing SPY at WVU include unplanned readmissions, unplanned return to OR, organ space SSI, superficial SSI, and wound dehiscence. Comparing national SPY use, hospitals without SPY report above national NSQIP in post-op occurrences and readmissions. Hospitals with SPY are below in both categories.
The patient population in WV is more likely to have higher co-morbidities and the future study goal is to separate groups based on comorbidities to look for differences amongst "healthier" and "unhealthier" patients. With a larger patient pool, we hope to effectively select who will truly benefit from use of SPY Elite. This information will allow us to optimize surgical care and possibly hospital costs
