Perioperative Vitamin D Insufficiency Impacts Postoperative Outcomes in Abdominally Based Breast Reconstruction.

Abstract

Background: Hypovitaminosis D has been associated with wound healing complications in animal models as well as increased morbidity, infection, and hospital length of stay in clinical studies of surgical patients. This study aims to evaluate the association between perioperative Vitamin D (25-OHD) levels and postoperative outcomes in patients undergoing autologous breast reconstruction.

Methods: We performed a retrospective review of patients undergoing autologous breast reconstruction at an academic institution. Patients with 25-OHD levels measured within three months of reconstruction were included. Variables of interest included patient demographics, comorbidities, perioperative 25-OHD levels, and postoperative surgical and medical complications. Standard statistical analysis was performed with significance set to p<0.05.

Results: 147 patients who underwent abdominally based breast reconstruction had undergone 25-OHD testing within three months of reconstruction and were included in analysis. 25-OHD insufficiency (<30 ng/mL) was found to be significantly associated with surgical site infections (OR 2.8, p=0.04), donor site seromas (OR 13.2, p=0.01), and medical complications (OR 4.0, p=0.02) on univariate and multivariable analysis.

Conclusion: Our data suggests that 25-OHD insufficiency impacts surgical and medical complications in patients undergoing autologous breast reconstruction. Enhanced understanding of perioperative 25-OHD status may help inform clinical decisions and present opportunities for optimizing patients to improve surgical outcomes in breast reconstruction.