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In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury
Published on: June 8, 2013
Ipsilateral pedicled TRAM flaps: the safer alternative?
P A Clugston1, M K Gingrass, D Azurin
1Department of Surgery, University of British Columbia, Vancouver, Canada. pac@unixg.ubc.ca
Plastic and Reconstructive Surgery
|January 8, 2000
Summary
Ipsilateral pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) flap breast reconstruction offers advantages over contralateral TRAM flaps. This study shows a lower partial flap necrosis rate of 2.0% with this preferred method.
Area of Science:
- Plastic Surgery
- Breast Reconstruction
- Microsurgery
Background:
- Transverse Rectus Abdominis Myocutaneous (TRAM) flap breast reconstruction is a common procedure.
- Concerns regarding pedicle compromise led to a preference for contralateral TRAM flaps.
- Previous studies reported high complication rates for pedicled TRAM flaps, including partial flap necrosis (5-44%).
Purpose of the Study:
- To evaluate the outcomes of ipsilateral pedicle TRAM flap breast reconstruction.
- To compare complication rates, particularly partial flap necrosis, with contralateral TRAM flaps.
- To identify risk factors for common complications in ipsilateral TRAM flap reconstructions.
Main Methods:
- A consecutive series of 252 ipsilateral TRAM flap reconstructions in 190 patients.
- Majority of patients underwent muscle-sparing procedures.
- Analysis of complication rates and risk factors.
Main Results:
- Partial flap necrosis rate was 2.0%, which is lower than previously reported series.
- Complication rates were comparable to contralateral TRAM flap series.
- Muscle-sparing techniques and immediate reconstruction with skin-sparing or skin-reduction procedures were frequently used.
Conclusions:
- Ipsilateral pedicle TRAM flap breast reconstruction is a preferred method due to its advantages.
- This technique demonstrates a lower partial flap necrosis rate compared to contralateral TRAM flaps.
- Further analysis of risk factors for complications is warranted.
