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References (8)
-
C. Hartrampf, G. Bennett (1987)
Autogenous tissue reconstruction in the mastectomy patient. A critical review of 300 patients.Annals of surgery, 205 5
-
Douglas Wagner, B. Michelow, C. Hartrampf (1991)
Double-pedicle TRAM flap for unilateral breast reconstruction.Plastic and reconstructive surgery, 88 6
-
T. Harashina, K. Sone, T. Inoue, S. Fukuzumi, K. Enomoto (1987)
Augmentation of circulation of pedicled transverse rectus abdominis musculocutaneous flaps by microvascular surgery.British journal of plastic surgery, 40 4
-
P. Clugston, M. Gingrass, D. Azurin, J. Fisher, Maxwell Gp (2000)
Ipsilateral Pedicled TRAM Flaps: The Safer Alternative?Plastic and Reconstructive Surgery, 105
-
C. Hartrampf, M. Scheflan, P. Black (1982)
Breast Reconstruction with a Transverse Abdominal Island FlapPlastic and Reconstructive Surgery, 69
-
G. Taylor, J. Palmer (1987)
The vascular territories (angiosomes) of the body: experimental study and clinical applications.British journal of plastic surgery, 40 2
-
C. Holm, M. Mayr, E. Höfter, M. Ninković (2006)
Perfusion Zones of the DIEP Flap Revisited: A Clinical StudyPlastic and Reconstructive Surgery, 117
-
R. Ng, Adel Youssef, S. Kronowitz, J. Lipa, J. Potochny, G. Reece (2004)
Technical variations of the bipedicled TRAM flap in unilateral breast reconstruction: effects of conventional versus microsurgical techniques of pedicle transfer on complications rates.Plastic and reconstructive surgery, 114 2
- Publisher
- Springer Journals
- Copyright
- Copyright © 2009 by Springer-Verlag
- Subject
- Medicine & Public Health; Plastic Surgery
- ISSN
- 0930-343X
- eISSN
- 1435-0130
- DOI
- 10.1007/s00238-009-0341-8
- Publisher site
- See Article on Publisher Site
Abstract
The transverse rectus abdominis myocutaneous (TRAM) flap is the most common method of autogenous breast reconstruction. In high-risk patients, a reliable and bulky flap is needed to achieve breast symmetry and a mound together with durable satisfactory projection. The purpose of this study is to look into the use of contralateral zones of the pedicled TRAM flap to improve flap survival and to reduce the incidence of fat necrosis in order to achieve good cosmetic results. Seven obese large-breasted patients of cup size C and above who underwent primary breast reconstruction by the same surgeon are presented. In each case, all the four zones of the TRAM flap were used to achieve symmetry of the reconstruction. Patients had mastectomy with or without axillary clearance. The pedicled TRAM flap was elevated and the other side was raised as a perforator flap for microvascular augmentation. The perforator vascular pedicle was anastomosed to the thoracodorsal vessels in all cases. The anterior rectus sheath was repaired with a mesh in all cases. All the flaps were coned to achieve a good projection. All flaps survived with no complications or loss. All patients were satisfied with the outcome. One of our patients developed an abdominal bulge that was treated conservatively. Microvascular augmentation improved survival of zones III and IV of the TRAM flap, exemplified by flap survival and no incidence of fat necrosis. It is a good reconstructive tool to achieve breast volume, symmetry, and projection. In addition, it reduces the need of secondary breast surgery for the contralateral breast in the future.
Journal
European Journal of Plastic Surgery – Springer Journals
Published: Oct 1, 2009