Sense and sensibility: breast reconstruction with innervated TRAM flaps

During a 25-month period, ten patients underwent post-oncologic breast reconstruction with innervated TRAM flaps. All patients were noted to have a more rapid and full return of sensation by the modalities tested than has been reported among patients with non-innervated TRAM-flap reconstructions. No complications relating to the microneural surgery were noted. Three patients experienced complications common to flaps in general: specifically, these were skin-flap necrosis in the cutaneous portion of one flap, skin necrosis of the infraumbilical skin flap at the closure site, and abdominal bulging at the donor area. Given the minimal increase in operating time required for the completion of the innervated TRAM-flap reconstruction and the obvious benefits in terms of postoperative sensation, this seems potentially to be an important modification to what is already a well-established technique.