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Developing a Breast Reconstruction Program in a Resource-Constrained Ghanaian Teaching Hospital: Needs Assessment and
Joshua T Tieman1, Maziar Mohsen Nourian1, Pius Agbenorku2
1From the Division of Plastic Surgery, University of Utah Health Sciences Center, Salt Lake City, UT.
Annals of Plastic Surgery
|January 15, 2021
Summary
Breast cancer mastectomy rates are rising in Ghana, increasing the need for breast reconstruction. The midabdominal transverse rectus abdominis myocutaneous (TRAM) flap is identified as the most reliable and satisfactory option for patients.
Area of Science:
- Oncology
- Plastic Surgery
- Public Health
Background:
- Improved breast cancer detection in Ghana has led to increased mastectomy rates and better patient outcomes.
- This trend necessitates a greater focus on breast reconstruction to address patient needs and reduce cultural hesitation.
- Making breast reconstruction accessible, affordable, and culturally acceptable is crucial.
Purpose of the Study:
- To evaluate and determine the optimal breast reconstruction method considering cultural, economic, and technical factors in Ghana.
- To address the growing demand for breast reconstruction following mastectomy.
Main Methods:
- A comprehensive review of reconstructive options through discussions, lectures, and cadaver dissections.
- Surgical implementation and evaluation of latissimus musculocutaneous flaps, lower abdominal TRAM flaps, and midabdominal TRAM flaps.
- Assessment of flap reliability, perfusion, and patient satisfaction.
Main Results:
- The midabdominal transverse rectus abdominis myocutaneous (TRAM) flap emerged as the preferred method at Komfo Anokye Teaching Hospital.
- This flap demonstrated reliability, robustness, and adequate perfusion.
- The single-stage procedure resulted in excellent patient satisfaction.
Conclusions:
- The midabdominal TRAM flap is a highly effective and reliable option for breast reconstruction in the Ghanaian context.
- Addressing cultural and economic factors alongside technical considerations is key to successful breast reconstruction.
- This method offers a viable solution to improve the quality of life for post-mastectomy patients.
