Extended transverse rectus abdominis musculocutaneous flap

Area of Science:

• Microsurgery
• Plastic Surgery
• Breast Reconstruction

Background:

• The transverse rectus abdominis musculocutaneous (TRAM) flap is a common choice for breast reconstruction.
• The TRAM flap's inherent limitation is its relatively poor blood supply, potentially affecting outcomes.
• Previous research suggested augmenting the TRAM flap's vascularity by including superficial epigastric and superficial circumflex iliac vessels.

Purpose of the Study:

• To evaluate the utility of incorporating external pudendal vessels for "supercharging" the TRAM flap.
• To expand the options for improving the blood supply of TRAM flaps in breast reconstruction.

Main Methods:

• Review of subsequent clinical experience following the initial description of TRAM flap supercharging.
• Surgical technique involving the identification and anastomosis of external pudendal vessels to the TRAM flap.

Main Results:

• Demonstrated successful utilization of external pudendal vessels for TRAM flap supercharging.
• Indicated that this method is a viable option for enhancing flap vascularity.

Conclusions:

• The external pudendal vessels represent an additional, effective source for supercharging the TRAM flap.
• Expanding supercharging techniques can improve the reliability and success of TRAM flap breast reconstruction.