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[Breast reconstruction using free rectus abdominis myocutaneous flap]
M A Germain1, L Barreau-Pouhaer, M C Missana
1Département de Chirurgie cervico-faciale et ORL, Institut Gustave-Roussy, Villejuif, France.
Chirurgie; Memoires De L'Academie De Chirurgie
|January 1, 1997
Summary
Immediate breast reconstruction using the free transverse rectus abdominis myocutaneous (TRAM) flap offers a natural breast shape without prostheses. This technique provides excellent outcomes with few complications, including an abdominoplasty effect.
Area of Science:
- Plastic Surgery
- Oncologic Surgery
- Reconstructive Surgery
Context:
- Breast cancer treatment often involves mastectomy, necessitating reconstruction.
- Since 1976, breast reconstruction techniques have evolved, including flap-based methods.
- Over 1100 immediate breast reconstructions were performed using prosthesis or pedicled flaps between 1976-1995.
Purpose:
- To evaluate the efficacy and outcomes of immediate breast reconstruction using the free transverse rectus abdominis myocutaneous (TRAM) flap.
- To compare the free TRAM flap technique with other reconstruction methods.
Summary:
- Between 1990-1995, 5 free TRAM flaps and 6 TURBOTRAM procedures were performed for immediate breast reconstruction.
- Free TRAM flap reconstruction resulted in a 80% success rate, with one case of partial necrosis (4x4 cm).
- All 6 TURBOTRAM operations were uneventful, demonstrating a high safety profile.
Impact:
- The free TRAM flap allows for extensive thoracic skin resection, creating a natural breast form without implants.
- This technique offers the dual benefit of breast reconstruction and abdominoplasty, with a low incidence of abdominal hernia.
- The study advocates for the increased use of the free TRAM flap in immediate breast reconstruction for suitable candidates.