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 .
A randomised trial of nursing interventions supporting recovery of the postmastectomy patient.
AIMS AND OBJECTIVES This ABC to recovery study evaluated the combined and separate components of preoperative education and the effectiveness of wearing the Papilla Gown . BACKGROUND Surgical removal of the breast may lead to activity limitation , self-image issues , discomfort and later complication of lymphoedema . Design . This study used experimental and longitudinal design . METHODS One hundred and forty-five women undergoing mastectomies for stages two and three breast cancer were r and omised into four groups : education and Papilla Gown , education only , gown only and control . The outcomes of activity ( A ) , body image ( B ) , comfort ( C ) , knowledge and lymphoedema were assessed at baseline and /or 1 week and 6 months using three measures . All 145 participants completed the study question naires at first two measures , and forty-six of these participants completed the question naires at 6 months postoperatively . The setting for the study included two clinics and hospitals . To examine statistical significance at each time point after surgery , 2-way anovas were performed on ABC , knowledge and tape measurement to see whether there were any statistically significant differences between the four groups . All reported p-values are two sided . All statistical analyses were performed using sas 9.2 for Windows . RESULTS The mean age of the sample was 55 years . The study revealed that women who received the combined intervention demonstrated greater activity . Women who wore the gown only had a greater comfort level and decreased lymphoedema . Women that received preoperative education experienced increased knowledge . CONCLUSIONS Outcomes suggest that the combined intervention ( ABCs to recovery ) can improve recovery following mastectomy . Relevance to clinical practice . The results will be used to further modify the intervention and to increase awareness of nurse practitioners and other healthcare professionals of the specific needs of postmastectomy patients
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 .