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Cost Effectiveness of Routine Utilization of Laser-Assisted Indocyanine Green Angiography in Immediate Breast Reconstruction
Shayda Mirhaidari
Douglas Wagner
Summa Health System
2017-02-14
Presenter: Shayda Mirhaidari
Affidavit:
I certify that the above abstract is of the original work of the author/resident.
Director Name: Douglas Wagner
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
BACKGROUND:
Complication rates following immediate breast reconstruction have ranged from 4-60%. Mastectomy skin flap necrosis is often the sentinel event leading to secondary complications such as reoperation and/or implant loss. The recent use of laser-assisted indocyanine green angiography (LAIGA) in immediate breast reconstruction has been shown to reduce the incidence of mastectomy skin flap necrosis (MSFN), implant loss, and overall unexpected reoperation rate. Further review is required to evaluate the cost effectiveness of LAIGA on the healthcare system.
METHODS:
A retrospective review of prospectively gathered data was performed on patients undergoing immediate breast reconstruction with the use of LAIGA from January 2014 to January 2015. The incidence of complications such as MSFN, unexpected reoperation, and implant loss were recorded and compared to a historical cohort of patients undergoing breast reconstruction prior to the introduction of LAIGA. The average cost of unexpected reoperation for patients experiencing MSFN was calculated. This was compared to the cost of using LAIGA in patients undergoing immediate breast reconstruction.
RESULTS:
There were 126 patients who had 206 immediate breast reconstructions using LAIGA from January 2014 to January 2015. There were 194 immediate breast reconstructions that did not use LAIGA in the historical cohort. The average cost of reoperation for MSFN was found to be more than the cost of using routine LAIGA.
CONCLUSION:
The use of LAIGA in immediate breast reconstruction reduces the incidence of MSFN, implant loss, and overall unexpected reoperation rate. LAIGA has shown to be a cost effective technology on the healthcare system.
