Priority 20 from the Post Mastectomy Breast Reconstruction PSP

UNCERTAINTY: How can complications be prevented after post mastectomy breast reconstruction? (JLA PSP Priority 20)
Overall ranking	20
JLA question ID	0109/20
Explanatory note	Not available
Evidence	Wound drainage after plastic and reconstructive surgery of the breast. Khan, Sameena M. Smeulders, Mark J. Van der Horst, Chantal M. Cochrane Database of Systematic Reviews. 10, 2015. Fibrin glue instillation under skin flaps to prevent seroma-related morbidity following breast and axillary surgery. Sajid, Muhammad S. Hutson, Kristian H. Rapisarda, Ignazio F. Bonomi, Riccardo. Cochrane Database of Systematic Reviews. 5, 2013 Breast reconstruction following prophylactic or therapeutic mastectomy for breast cancer. Alberta Health Services - Cancer Care Published on: 2017-02 MIB97: TopClosure Tension Relief System for wound closure Advice on the use of the TopClosure Tension Relief System for wound closure to aid local decision-making. Medtech innovation briefing Published March 2017. Early and locally advanced breast cancer: diagnosis and management Evidence-based recommendations on diagnosing and managing early and locally advanced breast cancer. NICE guideline Published July 2018
Health Research Classification System category	Cancer

Extra information provided by this PSP
Original uncertainty examples	More long term information about reconstructed breasts is much needed. For example: 1.what to expect with aging breast reconstruction, particularly when both breasts are not constructed/modified the same way….. ~ Recovery had a bit of a hiccup as one of my drains (right breast) never worked so the surgeon had to keep aspirating that side. It kept forming seromas for months. That was the only minor issue with me. My long term results have been very good. ~ How long drains would be needed. How quickly to return to normal activities and sports. ~ What percent of patients have infections? How many follow up appointments are required? What are the risks?
Submitted by	157 Patients and Care-givers, 63 Clinicians

Extra information provided by this PSP

Original uncertainty examples

More long term information about reconstructed breasts is much needed. For example: 1.what to expect with aging breast reconstruction, particularly when both breasts are not constructed/modified the same way….. ~ Recovery had a bit of a hiccup as one of my drains (right breast) never worked so the surgeon had to keep aspirating that side. It kept forming seromas for months. That was the only minor issue with me. My long term results have been very good. ~ How long drains would be needed. How quickly to return to normal activities and sports. ~ What percent of patients have infections? How many follow up appointments are required? What are the risks?

Submitted by

157 Patients and Care-givers, 63 Clinicians

PSP information
PSP unique ID	0109
PSP name	Post Mastectomy Breast Reconstruction
Total number of uncertainties identified by this PSP.	86 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	2 July 2019