Key recommendations support use of  opioid-sparing perioperative medications  , minimal preoperative fasting and early feeding , use of anesthetic techniques that decrease postoperative nausea and vomiting and pain , use of measures to prevent intraoperative hypothermia , and support of early mobilization after surgery .
Background : Enhanced recovery following surgery can be achieved through the introduction of evidence -based perioperative maneuvers .
This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery  and to provide evidence -based recommendations for an enhanced perioperative protocol .
Evidence-Based Protocol for Infection Control in Immediate Implant-Based Breast Reconstruction
Abstract Immediate breast implant reconstruction has among the highest incidence of infections in plastic surgery . A literature search returned key articles that showed a significant decrease in surgical-site infections by performing nasal swab evaluation to treat methicillin-sensitive and methicillin-resistant Staphylococcus aureus before surgery with mupirocin nasal ointment and 5 days of chlorhexidine scrub to the surgical area . Additional Level 1 data supported the use of chlorhexidine-alcohol over povidone-iodine solutions for skin preparation . Intraoperative data on breast pocket irrigation showed the benefits of povidone-iodine as well as a triple antibiotic solution . Nasal swabs from 120 patients showed no methicillin-resistant S. aureus but did identify 10 patients with methicillin-sensitive S. aureus , 1 with streptococcus , and 3 with gram-negative rods , which changed perioperative antibiotic management . On the basis of the previously mentioned data , an evidence -based protocol for infection control was developed to potentially decrease infection rates . Further cost and efficacy data are warranted
Key recommendations support use of  opioid-sparing perioperative medications  , minimal preoperative fasting and early feeding , use of anesthetic techniques that decrease postoperative nausea and vomiting and pain , use of measures to prevent intraoperative hypothermia , and support of early mobilization after surgery .
Background : Enhanced recovery following surgery can be achieved through the introduction of evidence -based perioperative maneuvers .
This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery  and to provide evidence -based recommendations for an enhanced perioperative protocol .