Related Experiment Videos
Double-pedicle TRAM flap for unilateral breast reconstruction
D S Wagner1, B J Michelow, C R Hartrampf
1Division of Plastic Surgery, Akron City Hospital, Ohio.
Plastic and Reconstructive Surgery
|December 11, 1991
Summary
Autogenous breast reconstruction using the transverse rectus abdominis myocutaneous (TRAM) flap is a common procedure. This study refines indications for single-pedicle and double-pedicle TRAM flaps in unilateral breast reconstruction.
Area of Science:
- Plastic Surgery
- Surgical Oncology
- Reconstructive Surgery
Background:
- Autogenous breast reconstruction utilizing the pedicled transverse rectus abdominis myocutaneous (TRAM) flap is a well-established technique.
- Over 500 patients have undergone TRAM flap breast reconstruction in this series, providing extensive clinical experience.
- Refinement of surgical techniques and patient selection criteria is crucial for optimizing outcomes in breast reconstruction.
Purpose of the Study:
- To delineate specific indications for employing both single-pedicle and double-pedicle TRAM flaps in unilateral breast reconstruction.
- To analyze the evolving utilization trends of the double-pedicle TRAM flap in recent cases.
- To provide a detailed description of the technique and outcomes associated with the double-pedicle TRAM flap procedure.
Main Methods:
- Retrospective analysis of 500 autogenous breast reconstructions using pedicled TRAM flaps.
- Categorization of flap techniques into single-pedicle and double-pedicle TRAM flaps for unilateral reconstructions.
- Comparative analysis of flap selection in historical versus recent cohorts of modified radical mastectomy reconstructions.
Main Results:
- In 341 unilateral breast reconstructions, the double-pedicle TRAM flap was used in 19% of cases.
- In the most recent 50 unilateral modified radical mastectomy reconstructions, the double-pedicle TRAM flap utilization increased to 60%.
- The single-pedicle TRAM flap remains the preferred choice for most unilateral reconstructions following a modified radical mastectomy.
Conclusions:
- The single-pedicle TRAM flap is generally the preferred method for unilateral breast reconstruction after a modified radical mastectomy.
- Careful patient selection is paramount to ensure the added safety and benefits of the double-pedicle TRAM flap procedure.
- The study details the indications, surgical technique, and outcomes for the double-pedicle TRAM flap, supporting its judicious use in select cases.