Abdominal Closure after TRAM Flap Breast Reconstruction with Transversus Abdominis Muscle Release and Mesh
Antonio Espinosa-de-Los-Monteros1, Héctor Avendano-Peza1, Yuri W Novitsky1
1Department of Plastic Surgery, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico; and Case Comprehensive Hernia Center, Department of Surgery, University Hospitals Case Medical Center, Cleveland, Ohio.
Abstract:
Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction.
