Pulmonary Function After Pedicled Transverse Rectus Abdominis Musculocutaneous Flap Breast Reconstruction

Area of Science:

• Plastic Surgery
• Thoracic Surgery
• Pulmonary Medicine

Background:

• Tight abdominal closures in TRAM flap breast reconstruction increase intra-abdominal pressure.
• This pressure can decrease lung compliance and increase breathing workload.

Purpose of the Study:

• To quantify changes in pulmonary function after pedicled TRAM flap breast reconstruction.
• To identify patient factors influencing these pulmonary changes.

Main Methods:

• Prospective clinical trial with 22 women undergoing TRAM flap breast reconstruction.
• Pulmonary function tests (PFTs) conducted preoperatively, 24 hours postoperatively, and 2 months postoperatively.
• Patients stratified by age, TRAM flap type, smoking status, and BMI; data analyzed using ANOVA and t-tests.

Main Results:

• PFT values, except residual volume, were significantly lower 24 hours post-surgery.
• Smokers had less PFT decline but poorer baseline function; older patients (>50) showed greater decline in FRC and RV.
• No significant difference in PFT changes between unilateral and bilateral flaps.
• Pulmonary function returned to baseline by 2 months post-surgery.

Conclusions:

• Pedicled TRAM flap breast reconstruction leads to a significant, temporary decrease in pulmonary function.
• Age and smoking status are factors influencing the degree of pulmonary function impairment.
• Pulmonary function generally recovers to preoperative levels within two months.