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Experience with the ipsilateral upper TRAM flap for postmastectomy breast reconstruction
R P Mukherjee1, V Gottlieb, L C Hacker
1Marshfield Clinic, WI 54449.
Annals of Plastic Surgery
|September 1, 1989
Summary
The ipsilateral upper transverse rectus abdominis musculocutaneous (TRAM) flap offers superior outcomes for postmastectomy breast reconstruction. This method provides a more reliable blood supply and simpler abdominal wall repair compared to the lower TRAM flap.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Mastectomy often necessitates breast reconstruction.
- Transverse rectus abdominis musculocutaneous (TRAM) flaps are a common reconstructive option.
- The choice between upper and lower TRAM flaps impacts surgical outcomes.
Purpose of the Study:
- To present outcomes of postmastectomy breast reconstruction using the ipsilateral upper TRAM flap.
- To compare the advantages of the ipsilateral upper TRAM flap over the lower TRAM flap.
Main Methods:
- Retrospective review of 27 patients undergoing postmastectomy breast reconstruction.
- Utilized the ipsilateral upper transverse rectus abdominis musculocutaneous (TRAM) flap.
- Evaluated flap viability, donor site morbidity, and operative parameters.
Main Results:
- The ipsilateral upper TRAM flap demonstrated a strong and predictable blood supply.
- Abdominal wall repair was noted to be easier and stronger.
- Shorter operating times and reduced blood loss were observed.
- The donor site exhibited acceptable cosmetic results.
Conclusions:
- The ipsilateral upper TRAM flap is a favorable option for postmastectomy breast reconstruction.
- It offers advantages in terms of vascularity, abdominal wall integrity, surgical efficiency, and aesthetics.
- This technique presents a viable alternative to the lower TRAM flap.