{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T01:02:15Z","timestamp":1771376535103,"version":"3.50.1"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Abdominally based free flaps are commonly utilized in the context of breast reconstruction. Historically, postoperative care of these patients involved liberal amounts of intravenous fluid administration; however, overadministration of fluids puts patients at risk of developing flap edema via fluid shifts, electrolyte imbalances, wound dehiscence, and other sequelae. The purpose of this study is to assess fluid administration trends in this cohort at the authors' institution and assess its impact on patient outcomes.<\/jats:p>\n                  <jats:p>A retrospective review was performed on patients who underwent free-flap breast reconstruction. Patient demographics and hospitalization data were collected, and type of abdominal flap and reconstruction timing was noted. Perioperative fluid administration volumes were tracked, and primary outcomes included complication rate and type (e.g., acute blood loss anemia [ABLA], partial\/total flap loss, etc.). Multivariable logistic regression was performed to assess the impact of fluid volume on patient outcomes.<\/jats:p>\n                  <jats:p>A total of 115 patients (mean age of 51.3\u2009\u00b1\u200910.5 years) underwent 188 abdominally based free flaps. Deep inferior epigastric artery perforator flaps were performed most often (n\u2009=\u200991), followed by muscle-sparing transverse rectus abdominis flaps (n\u2009=\u200988). Multivariable logistic regression demonstrated that high perioperative fluid administration (\u22659,000\u2009mL) was associated with increased odds of medical complications (odds ratio [OR]\u2009=\u200921.7; confidence interval [CI]: 5.54\u201384.5; p\u2009&lt;\u20090.001). Patients with high fluid administration volumes experienced an increased (but nonstatistically significant) flap complication rate (OR\u2009=\u20092.96; CI: 0.89\u20139.88; p\u2009=\u20090.08) and developed ABLA at a higher rate (OR\u2009=\u200915.86; CI: 5.30\u201346.4; p\u2009&lt;\u20090.001).<\/jats:p>\n                  <jats:p>High-volume resuscitation (\u22659,000\u2009mL) was associated with increased odds of ABLA as well as a greater likelihood of medical and flap complications in patients undergoing abdominally based free flaps for breast reconstruction. These data should be used to guide the development of protocols within institutions, which perform free flaps for breast reconstruction.<\/jats:p>","DOI":"10.1055\/a-2616-4598","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T20:13:11Z","timestamp":1747771991000},"page":"214-221","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Judicious Fluid Administration in the Setting of Abdominally Based Free Flaps"],"prefix":"10.1055","volume":"42","author":[{"given":"Lyndsay A.","family":"Kandi","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole Van","family":"Spronsen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic in Arizona, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0223-4698","authenticated-orcid":false,"suffix":"Jr","given":"W. Nicholas","family":"Jungbauer","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic in Arizona, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Sexton","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Connecticut, Farmington, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nellie","family":"Movtchan","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic in Arizona, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hui","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Reece","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic in Arizona, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alanna M.","family":"Rebecca","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic in Arizona, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"William J.","family":"Casey","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic in Arizona, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"issue":"05","key":"ref1","first-page":"1237","article-title":"Breast reconstruction 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Surg"},{"issue":"09","key":"ref13","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1055\/s-0039-1693699","article-title":"Enhanced recovery after surgery in breast reconstruction: a systematic review","volume":"35","author":"C E Soteropulos","year":"2019","journal-title":"J Reconstr Microsurg"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"e38487","DOI":"10.2196\/38487","article-title":"Effect of the Red Bull energy drink on perfusion-related variables in women undergoing microsurgical breast reconstruction: protocol and analysis plan for a prospective, multicenter randomized controlled trial","volume":"12","author":"N E Speck","year":"2023","journal-title":"JMIR Res Protoc"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"1056e","DOI":"10.1097\/PRS.0000000000003242","article-title":"Consensus review of optimal perioperative care in breast reconstruction: Enhanced Recovery after Surgery (ERAS) Society recommendations","volume":"139","author":"C Temple-Oberle","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1055\/a-1939-5874","article-title":"Hyponatremia after autologous breast reconstruction: a cohort study comparing two fluid management protocols","volume":"39","author":"F Ruccia","year":"2023","journal-title":"J Reconstr Microsurg"},{"key":"ref17","volume-title":"Transfusion Transmitted Disease","author":"A A Justiz Vaillant","year":"2024"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1055\/a-2506-1763","article-title":"Effect of enhanced recovery after surgery in morbidly obese patients undergoing free flap breast reconstruction","author":"K L Stephens","year":"2025","journal-title":"J Reconstr Microsurg"},{"issue":"07","key":"ref19","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1055\/s-0039-1687914","article-title":"Perioperative vasopressor use in free flap surgery: a systematic review and meta-analysis","volume":"35","author":"C SL Goh","year":"2019","journal-title":"J Reconstr Microsurg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"zxae330","DOI":"10.1093\/ajhp\/zxae330","article-title":"Large-volume intravenous fluid use before and after implementation of a fluid conservation strategy","author":"J Carr","year":"2024","journal-title":"Am J Health Syst Pharm"}],"container-title":["Journal of Reconstructive 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