Immediate TRAM flap breast reconstruction: 128 consecutive cases

Area of Science:

• Plastic Surgery
• Oncology
• Reconstructive Surgery

Background:

• Immediate breast reconstruction aims to restore aesthetics post-mastectomy.
• The transverse rectus abdominis musculocutaneous (TRAM) flap is a common technique.
• Assessing the efficacy and safety of TRAM flap for immediate reconstruction is crucial.

Purpose of the Study:

• To evaluate the transverse rectus abdominis musculocutaneous (TRAM) flap procedure for immediate breast reconstruction.
• To compare the outcomes of conventional TRAM versus free TRAM flaps.
• To assess the feasibility and complication rates of immediate TRAM flap breast reconstruction.

Main Methods:

• Retrospective analysis of 128 consecutive patients undergoing immediate breast reconstruction with TRAM flaps (1985-1990).
• Categorization into conventional TRAM (86 patients) and free TRAM (40 patients) groups.
• Evaluation of hospitalization time, fat necrosis incidence, local recurrence, and operative complications.

Main Results:

• Free TRAM flap associated with shorter hospitalization and reduced fat necrosis compared to conventional TRAM.
• No increased risk of local recurrence observed with immediate breast reconstruction.
• Chemotherapy delayed in one patient due to healing issues; overall complication rates appear to be improving.

Conclusions:

• The TRAM flap procedure, especially the free TRAM variation, is a viable and primary option for immediate breast reconstruction.
• The free TRAM flap demonstrates improved outcomes regarding recovery and complications.
• Immediate breast reconstruction using TRAM flaps shows promising results with acceptable safety profiles.