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 .
[Antibiotic prophylaxis in breast surgery. Preliminary resuls of a multicenter randomized study on 1400 cases].
UNLABELLED Breast surgery is classified among the procedures performed in clean surgery and is associated with a low incidence of wound infection ( 3 - 15 % ) . The objective of this study was to evaluate the advantages antibiotic prophylaxis  in patients undergoing breast surgery .  A multicenter r and omized controlled study was performed between January 2008 and November 2008 . One thous and four hundred patients were enrolled in prospect i ve r and omized study ; surgical wound infection was found in 41 patients ( 2.93 % ) . In our RCT we have shown that in breast surgery antibiotic prophylaxis does not present significant advantages in patients with potential risk of infection ( 17 patients , 2.42 % , subjected to antibiotic prophylaxis vs 24 patients , 3.43 % , without antibiotic prophylaxis ) ( P = 0.27 ) . In patients with drainage there is a significant minor incidence of wound infections in patients receiving antibiotic prophylaxis ( 5 patients , 0.92 % , subjected to antibiotic prophylaxis vs 14 patients , 3.09 % , without antibiotic prophylaxis ) ( P = 0.02 ) . CONCLUSION This study is only a preliminary RCT to be followed by a study which should be enrolled more patients in order to get the results as statistically significant
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 .