Characterizing At-Home Recovery After DIEP Flap Reconstruction Using A Remote Symptom Monitoring Tool
Year: 2026
Type: conference-paper
Study design: Observational Study
Abstract: Background: Enhanced Recovery After Surgery (ERAS) protocols for deep inferior epigastric artery perforator (DIEP) flap reconstruction at our institution shortened hospital stays to two days or less, shifting recovery to the outpatient setting. To support patients post-discharge, we implemented the Recovery Tracker, a remote symptom monitoring tool with automated alerts. While prior studies demonstrated its utility in other complex surgeries, none characterized DIEP flap recovery using this tool. Therefore, we aimed to use the Recovery Tracker to describe the 10-day postoperative recovery for early-discharge DIEP flap patients. Methods: We retrospectively reviewed patients who underwent DIEP flap reconstruction at our institution between May 2021 and November 2024. Bilateral flaps had a two-day length of stay, while unilateral DIEP flaps had a minimum of two-day stay before September 2021 and a one-day stay after this date, aligning with our discharge protocol change. Patients received the Recovery Tracker, an electronic patient-reported outcome (ePRO) platform used to assess symptoms for 10 postoperative days. Prespecified symptom thresholds generated two automated alerts: yellow alerts (moderate severity) prompted office follow-up calls, and red alerts (most severe symptoms) instructed patients to contact their surgeon immediately while notifying the office team. We analyzed engagement rates with the Recovery Tracker, reported symptoms, and clinical alert generation. Results: The cohort included 412 patients who underwent DIEP flap reconstruction: 234 (57.0%) unilateral and 178 (43.0%) bilateral. The survey completion rate was higher for unilateral patients (43.1% vs. 38.0%; P<0.001), although overall patient participation was high, with 94.9% of unilateral and 93.3% of bilateral patients completing at least one survey. Pain was the most frequent symptom, reported by 191 unilateral (81.6%) and 139 bilateral (78.1%) patients, starting moderate to severe and steadily declining to mild. Swelling occurred in 73 unilateral (31.2%) and 45 bilateral (25.3%) patients; however, it was rarely severe. Nausea affected 46 unilateral (19.7%) and 33 bilateral (18.5%) patients, typically mild-to-moderate severity. Less common symptoms included flap color change, shortness of breath, and fatigue. No fevers or emesis were reported. Among unilateral patients, 92 (39.3%) generated yellow alerts and 26 (11.1%) generated red alerts. Among bilateral patients, 54 (30.3%) triggered yellow alerts and 16 (9.0%) triggered red alerts. Pain and swelling were the most common triggers for both yellow and red alerts. Thirteen unilateral (5.6%) and five bilateral (2.8%) patients were readmitted within 30 days. One unilateral patient experienced total flap loss. Conclusion: Remote symptom monitoring is a feasible and effective method to track at-home recovery in DIEP flap patients on an ERAS pathway. This is the first study to characterize the typical 10-day recovery and define patterns for common symptoms. These data can inform patient education, set realistic expectations, and enable early recognition of deviations from the expected recovery course. The integration of a remote symptom monitoring tool enhances safety for patients recovering at home and is a valuable adjunct to ERAS protocols.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/CS20.cgi*
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7160651191