Chetta Matthew D, Schoenbrunner Anna R, Lee Clara N
Department of Plastic and Reconstructive Surgery, The Ohio State University, Columbus, Ohio.
Plast Reconstr Surg Glob Open. 2020 Jun 9;8(6):e2967. doi: 10.1097/GOX.0000000000002967. eCollection 2020 Jun.
Breast reconstruction has a well-documented positive impact on the psychosocial well-being of women recovering from breast cancer. Rates of breast cancer diagnoses are rising, and more women are seeking mastectomy as treatment and as prophylaxis.
Postmastectomy breast reconstruction often begins at the time of mastectomy in coordination with the oncologic breast surgeons. Immediate breast reconstruction increases complication rate (11% vs 4%) and unplanned reoperation rate (7% vs 4%), requiring more personnel and resources used during the preoperative, intraoperative, and postoperative phases of patient care.
In the setting of global pandemics such as coronavirus disease 2019 (COVID-19), breast reconstruction demands a unique and nuanced approach, as most forms of breast reconstruction can occur successfully in a delayed fashion. While this may prolong the overall time until completion of reconstruction, other factors come into play in the setting of a communicable (potentially deadly) illness. Factors that must be considered include allocation of essential resources and protection of patients and families from disease transmission.
Plastic surgeons performing breast reconstruction must take these factors into account when counseling their patients, colleagues, and institutions and be proactive in determining which procedures are time-critical and which should be postponed until the disaster situation has relieved.
乳房重建对乳腺癌康复女性的心理社会幸福感有着充分记录的积极影响。乳腺癌诊断率在上升，越来越多的女性寻求乳房切除术作为治疗手段和预防措施。
乳房切除术后乳房重建通常在乳房切除术时与肿瘤乳腺外科医生协调进行。即刻乳房重建会增加并发症发生率（11% 对 4%）和非计划再次手术率（7% 对 4%），在患者护理的术前、术中和术后阶段需要更多的人员和资源。
在诸如2019冠状病毒病（COVID - 19）这样的全球大流行背景下，乳房重建需要一种独特且细致入微的方法，因为大多数形式的乳房重建可以成功地延迟进行。虽然这可能会延长重建完成的总体时间，但在传染性（可能致命）疾病的背景下还有其他因素需要考虑。必须考虑的因素包括基本资源的分配以及保护患者及其家人免受疾病传播。
进行乳房重建的整形外科医生在向患者、同事和机构提供咨询时必须考虑这些因素，并积极主动地确定哪些手术是时间紧迫的，哪些应该推迟到灾难情况缓解之后。
