The purpose of this study was to evaluate the correlation between risk factors and hernia or bulge formation at the donor site of the transverse rectus abdominis myocutaneous (TRAM) flap. A retrospective study was conducted between September 2005 and December 2008 in 206 patients who underwent breast reconstruction with pedicled TRAM flap. Eight (3.9%) of these patients had abdominal wall hernia and 26 (12.6%) had abdominal bulging. The incidence of hernia was significantly higher ( P < 0.05) among patients with body mass index (BMI) ≥ 30 kg/m 2 (hernia incidence, 15.0%) than that among patients with BMI <30 kg/m 2 (hernia incidence, 3.2%), while the incidence of abdominal bulge was significantly lower ( P < 0.05) among patients with BMI ≥ 30 kg/m 2 (abdominal bulge incidence, 5.0%) than that among patients with BMI ≥ 30 kg/m 2 (abdominal bulge incidence, 19.1%). Therefore, obesity was identified as a risk factor for abdominal wall hernia. It was also found that the use of mesh to reinforce the abdominal wall significantly reduced ( P < 0.025) the incidence of hernia (use of mesh (hernia incidence, 2.5%) versus non-mesh (hernia incidence, 5.9%)) and abdominal bulge (use of mesh (abdominal bulge incidence, 9.9%) versus non-mesh (abdominal bulge incidence, 17.3%)) among the patients.
European Journal of Plastic Surgery – Springer Journals
Published: Aug 1, 2010
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