[Apropos of 49 transverse rectus abdominis muscle flap (TRAM) in carcinologic and reconstructive surgery]

The C.A.C. de Nice reconstructive surgery unit presents their experience of TRAM pedicled flap (41 cases) or free flap (8 cases). The technical details, complications and sequelae are analysed for the entire series of flaps with particular attention to the problems of the abdominal wall and the respective advantages of the two techniques. The applications of TRAM essentially concern breast reconstruction (41 cases) in women with large breasts and not desiring an implant or a contralateral procedure. TRAM is compared to other procedures (latissimus dorsi, implant, greater omentum) which the authors consider to be valid alternatives. The other indications are reconstructive, either for the chest wall (5 cases) or inguinoperineal (3 cases) for defects in an irradiated region.