[Analysis of 156 breast reconstructions by transverse rectus abdominis muscle flap (TRAM)]

The myocutaneous rectus abdominis flap described by Hartrampf was used for 156 breast reconstructions between 1982 and 1992. 107 reconstructions were done with one pedicle. 142 were delayed reconstructions. Partial necrosis of the flap occurred in 10% of the cases in bipedicled flaps and 20% in unilateral flaps. No hernia occurred in this series. Cosmetic results are considered satisfactory or very satisfactory in 59% of the cases when evaluated by the medical team and 76.5% when evaluated by the patients. As a conclusion of this study, the TRAM flap is preferred in delayed reconstructions when local and general conditions are suitable, rather than latissimus dorsi flap reconstructions which require an implant.