key: cord-1011709-xbtvj4q2
authors: Salgarello, Marzia; Adesi, Liliana Barone; Visconti, Giuseppe; Pagliara, Domenico Maria; Mangialardi, Maria Lucia
title: Considerations for performing immediate breast reconstruction during the COVID‐19 pandemic
date: 2020-05-07
journal: Breast J
DOI: 10.1111/tbj.13876
sha: 525ca2610208ee6adb51efc33a4b3476946bc191
doc_id: 1011709
cord_uid: xbtvj4q2

nan

The appearance of coronavirus disease 2019 (COVID-19) has provoked a global public health emergency, spreading to more than 150 countries, 1 and Italy has been particularly affected.

The COVID-19 pandemic has represented a contemporary "sui generis" challenge for healthy system requiring a sudden reorga- Breast carcinoma is the most frequent malignancy among women, and its modern surgical treatment nowadays includes breast reconstruction. Given the rapid evolution of the current situation, very few data of the different breast units about the present attitude toward breast cancer management are available. 5 Breast surgeons seem to agree on the fact that delaying elective surgical procedures may be more appropriate for select cases such as clinical stage I or stage II in which 60-day delays in surgical intervention were not associated with worse oncological outcomes. 6, 7 To date, no guidelines on breast reconstructive surgery have been published. The aim of this article is to report our decision-making attitude during COVID-19 emergency in the field of breast reconstruction.

In line with government directives, our institution limits elective surgery to oncologic procedures, and the reconstructive time is con- 

SSM patients undergo two-stage IBR. In case of small breast, a subpectoral two-stage IBR is performed. In case of medium-large breast size with any ptosis degree, the mastectomy flap evaluation guides our choice.

A thick (>0.8 mm) and well-perfused flap allows a DTI polyurethanecovered IBR, while patients presenting a thin (<0.8 mm) and slightly perfused flap are addressed to a subpectoral two-stage reconstruction.

SRM patients undergo a DTI prepectoral polyurethane-covered IBR.

In these cases, we systematically harvest an inferior dermo-adipose flap to cover most of the implant.

In conclusion, we briefly reported our decision-making attitude for breast reconstruction during COVID-19 emergency with the aim to share our experience in this critical moment.

COVID-19 Coronovirus Pandemic

COVID-19: Guidance for triage of non-emergent surgical procedures

SARS-CoV-2 transmission in cancer patients of a tertiary hospital in Wuhan. medRxiv. 2020; e200980

Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China

International guidelines on radiation therapy for breast cancer during the COVID-19 pandemic

Timing of breast cancer surgery-how much does it matter?

A practical approach to the management of cancer patients during the novel coronavirus disease 2019 (COVID-19) pandemic: an international collaborative group

Breast reconstruction actualized in nipple-sparing mastectomy and direct-to-implant, prepectoral polyurethane positioning: early experience and preliminary results

Evaluation of the effectiveness of the pre-pectoral breast reconstruction with Braxon dermal matrix: First multicenter European report on 100 cases