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In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury
Published on: June 8, 2013
Cutaneous viability in a rat pedicled TRAM flap model.
Léo Francisco Doncatto1, Jefferson Braga da Silva, Vinícius Duval da Silva
1Porto Alegre, Brazil From the Plastic Surgery Service and Department of Pathology, Sao Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul.
Plastic and Reconstructive Surgery
|April 7, 2007
Summary
Necrosis in pedicled transverse rectus abdominis musculocutaneous (TRAM) flaps for breast reconstruction is highest in lateral areas. Areas 1 and 2 showed less necrosis, while areas 3 and 4 experienced significant cutaneous necrosis.
Area of Science:
- Plastic Surgery
- Surgical Oncology
- Reconstructive Surgery
Background:
- The transverse rectus abdominis musculocutaneous (TRAM) flap is a common technique for breast reconstruction.
- Pedicled TRAM flaps are associated with significant morbidity and complications.
- This study investigates necrosis patterns in pedicled TRAM flaps using a rat model.
Purpose of the Study:
- To determine the incidence and distribution of necrosis in pedicled TRAM flaps.
- To identify specific areas of the flap at higher risk for necrosis.
- To inform strategies for improving TRAM flap outcomes in breast reconstruction.
Main Methods:
- A pedicled TRAM flap procedure was performed on 35 female Wistar rats.
- The flap surface was divided into four distinct areas for analysis.
- Necrosis occurrence, percentage, and distribution were systematically recorded.
Main Results:
- Necrosis rates varied significantly across the four flap areas.
- Area 4 (lateral) showed 100% necrosis, Area 3 (lateral) showed 74% necrosis.
- Areas 1 (pedicle) and 2 (contralateral) exhibited lower necrosis rates of 9% and 37%, respectively.
Conclusions:
- Distinct levels of necrosis were identified, with lateral areas (3 and 4) demonstrating the highest rates.
- The medial and pedicle-adjacent areas (1 and 2) of the TRAM flap showed significantly less necrosis.
- These findings highlight the vulnerability of lateral flap portions to necrosis, informing surgical technique and patient selection.
