Deep Inferior Epigastric Perforator In-Basket? Evaluation of Patient Electronic Communication Following Autologous Breast Reconstruction.

Abstract

Background: Patient electronic communication (PEC) via secure messaging is important for patient engagement. While PEC has been studied in primary care, data on surgical specialties, particularly plastic surgery, remain limited.

Objectives: This study assessed the volume and content of post-discharge PECs among patients undergoing post-mastectomy autologous breast reconstruction.

Methods: We conducted a retrospective mixed-methods study of PECs from patients undergoing autologous breast reconstruction at a large academic institution from January 2021 to December 2023. Primary outcomes included the quantity and thematic content of PECs sent within 30 days post-discharge. Covariates of interest included patient demographics, comorbidities, and operative details. Quantitative analysis included descriptive statistics and multivariable regression to identify predictors of PEC frequency. Qualitative content analysis was used to identify thematic categories of PECs.

Results: A total of 297 patients underwent autologous breast reconstruction from January 2021 to December 2023. Of these, 230 patients (77.44%) sent 806 PECs within 30 days post-discharge. The most frequent message topics related to drains, wounds, pain, and activity restrictions. Younger age was a significant negative predictor of total PEC volume (p < .001) and wound-related (p=0.021) or pain-related (p<0.001) PECs, while immediate reconstruction was associated with more wound-related messages (p=0.011). Depression was a positive predictor of pain-related PECs (p=0.029).

Conclusions: This is the first comprehensive study evaluating the quantity and content of post-discharge PECs in a large cohort of patients undergoing autologous breast reconstruction. Understanding volume and content of PEC following autologous breast reconstruction may inform strategies for improving perioperative patient education.