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 .
Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial
Background One of the major risk variables for surgical site infection is wound management . Underst and ing infection risk factors for breast operations is essential in order to develop infection-prevention strategies and improve surgical outcomes . The aim of this trial is to assess the influence of  dressing wear time on surgical site infection rates and skin colonization . Patients ’ perception at self- assessment will also be analyzed . Methods / Design This is a two-arm r and omized controlled trial . Two hundred breast cancer patients undergoing immediate or delayed breast reconstruction will be prospect ively enrolled . Patients will be r and omly allocated to group I ( dressing removed on postoperative day one ) or group II ( dressing removed on postoperative day six ) . Surgical site infections will be defined by st and ard criteria from the Centers for Disease Control and Prevention ( CDC ) . Skin colonization will be assessed by culture of sample s collected at predefined time points . Patients will score dressing wear time with regard to safety , comfort and convenience . Discussion The evidence to support dressing st and ards for breast surgery wounds is empiric and scarce . CDC recommends protecting , with a sterile dressing for 24 to 48 hours postoperatively , a primarily closed incision , but there is no recommendation to cover this kind of incision beyond 48 hours , or on the appropriate time to shower or bathe with an uncovered incision . The results of the ongoing trial may support st and ard recommendations regarding dressing wear time after breast reconstruction . Trial registration Clinical Trials.gov identifier : http://www . clinical trials.gov/ct2/ results ? term = NCT01148823
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 .