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 .
Use of 2-Octyl-Cyanoacrylate Skin Adhesive (Dermabond) for Wound Closure following Reduction Mammaplasty: A Prospective, Randomized Intervention Study
Background : 2-Octyl-cyanoacrylate skin adhesive may be used for surgical wound closure . However , its use in plastic surgery has not been properly assessed . Methods : The authors conducted a prospect i ve , r and omized , controlled clinical intervention study in which the scar characteristics after use of skin adhesive were compared with those after suture closure .  Bilateral reduction mammaplasty was performed in 50 patients . The method of closure ( sutures versus skin adhesive ) applied to each breast was determined r and omly , using each patient as her own control . Scars were assessed by the patient and by a blinded panel , at 1 week , 6 weeks , and 6 months after surgery , using a visual analogue scale , the modified Holl and er Wound Evaluation Scale , and the Patient and Observer Scar Assessment Scale . Results : Both patients and panelists expressed an overall preference for the adhesive side as of 1 week after surgery . Patients ’ visual analogue scale scores for scar comfort and scar appearance and panelists ’ visual analogue scale scores for aesthetic outcome were significantly better for the adhesive side after 6 weeks and 6 months ( p < 0.05 ) , as was the total Holl and er Wound Evaluation Scale score of the panelists after 6 weeks ( p < 0.02 ) . The total Patient and Observer Scar Assessment Scale score after 6 months was significantly better for the adhesive side according to the patients ( p < 0.01 ) , but not according to the panelists ( p = 0.11 ) . Conclusion : The authors conclude that 2-octyl-cyanoacrylate is a sound alternative for wound closure
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 .