[Value of pulsed color Doppler before transverse rectus abdominis musculocutaneous flap breast reconstruction. 45...

The transverse rectus abdominis musculocutaneous TRAM flap is an interesting alternative for breast reconstruction after mastectomy for cancer disease in patients who refuse mammary prosthesis and when the clinical situation allows it. There is however a risk of unpredictable partial necrosis even after rigorous surgical procedure. Some authors have proposed a Doppler evaluation before reconstruction surgery to better identify the vascular network and optimize patient selection. We performed a preliminary study in 45 patients between January 1996 and December 1999. An echo-Doppler Ultramark 9 HDI (Advanced Technology Laboratories) equipped with a high frequency (10 MHz) linear probe was used to compare blood flow and vessel caliber in the superior epigastric artery and the perforating vessels (number, localization, peak flow). The results obtained in this series could be used to determine indications for TRAM flap with or without delay procedure.