Resuming autologous free tissue transfer for breast reconstruction in the COVID-19 era.

Summary The Royal College of Surgeons (RCS) guide to surgical prioritisation during the coronavirus pandemic states that breast reconstruction is Priority level 4 Surgery. In view of the associated increased mortality risk, and potential complications such as return to theatre, autologous free tissue transfer for breast reconstruction was withheld in our unit from the 12th March. It is the view in our regional centre that free tissue transfer for breast reconstruction should not be viewed as complex surgery. We believe in performing the correct operation, for the right patient, at the right time and we strive to adhere to the NHS improvement program 'Getting it right first time'. After widespread consultation with stakeholders both locally and nationally, as of June 3rd we re-started autologous free flap reconstruction. We describe our experience as the first unit in resuming this service during the COVID-19 pandemic.