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Obesity Should Not Prevent from TRAM Flap Breast Reconstruction in Developing Countries
Sadaf Alipour1, Ramesh Omranipour2, Rahim Akrami3
1Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran ; Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
Obesity does not negatively impact outcomes for Transverse Rectus Abdominis Musculocutaneous (TRAM) flap breast reconstruction. This study found similar results for obese and non-obese patients, suggesting obesity may not be a contraindication.
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Transverse Rectus Abdominis Musculocutaneous (TRAM) flap is a common breast reconstruction method.
- Obesity is often considered a relative contraindication for TRAM flap procedures.
- Existing techniques for obese patients involve complex modifications.
Purpose of the Study:
- To investigate the effect of body weight on TRAM flap breast reconstruction outcomes.
- To analyze ischemic complications in relation to patient body mass index (BMI).
Main Methods:
- Retrospective review of medical records for TRAM flap surgeries (1986-2011).
- Patients categorized into normal (<25 kg/m²), overweight (25-29.9 kg/m²), and obese (>30 kg/m²) BMI groups.
- Flap necrosis defined as visible nonviable tissue in the reconstructed breast.
Main Results:
- 59 patients included in the analysis: 24 normal BMI, 21 overweight, 14 obese.
- No flap necrosis requiring reoperation was observed in any patient group.
- Outcomes for obese patients undergoing TRAM flap reconstruction were similar to non-obese patients.
Conclusions:
- Obesity does not appear to be a significant contraindication for TRAM flap breast reconstruction.
- Current contraindications for obesity in TRAM flap surgery may need re-evaluation.
- Larger cohort studies are recommended to further validate these findings.
