Acceptance of Outpatient Enhanced Recovery after Surgery (Eras©) Protocols for Implant-Based Breast Reconstruction Nudged on by the Covid-19 Pandemic

We retrospectively identified 295 women undergoing outpatient implant breast reconstruction (IBR) who received standardized ERAS care pre-pandemic (April 2018 – March 2020) and post-pandemic (April 2020 – March 2022). The majority of IBR was completed as outpatient surgeries post-pandemic versus pre-pandemic (73% versus 38%, p<0.001). Immediate IBR increased post-pandemic versus pre-pandemic (p<0.001). Preoperative ERAS© order sets were used 54% of the time. Lack of ERAS© order set use was associated with unplanned admissions (55.3% versus 44.7%, p=0.02). COVID-19 changed health care and nudged IBR to outpatient procedures. With ERAS© recommendations, IBR can be safely and effectively transitioned to outpatient settings.