Experience with 50 Free TRAM Flap Breast Reconstructions

Arnež, Zoran Marij; Bajec, J.; Bardsley, A.F.; Scamp, T.; Webster, M.H.C.

doi:10.1097/00006534-199103000-00012

Cited by 91 publications

(12 citation statements)

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“…Both patients were given antithrombotic prophylaxis for four days after the operation. Our results are comparable to those of other studies in which total necrosis of the flap has varied from 1% to 6% [5,15,17].…”

Section: Discussionsupporting

confidence: 90%

“…Reduced bleeding and shorter operating times mean that more operations can be done in each operating room, which improves the cost:benefit ratio of free TRAM breast reconstructions. After a relatively short anaesthetic and after infiltrating the lines of incision before operation, patients seem to do better on the first operative day, and nowadays they are routinely discharged on day 5 which is much less that it used to be (over 11 days) [17].…”

Section: Discussionmentioning

confidence: 99%

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Breast reconstruction with free transverse rectus abdominis myocutaneous flaps in hospitals unaccustomed to microsurgery: Original retrospective study

Salmi¹

2005

Scandinavian Journal of Plastic and Reconstructive Surgery and

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We studied retrospectively 102 consecutive free TRAM breast reconstructions that were done outside our own hospital in hospitals that were not used to microsurgical techniques. Twenty-three patients were operated on by an uninfiltrated free TRAM technique, and 79 had 0.5% lignocaine with adrenaline infiltrated along the incision lines before the operation. We lost two flaps and six flaps developed necrosis of the medial edge. Our total complication rate (25%) compared well with those of other studies. Infiltration with lignocaine and adrenaline significantly decreased the operating time (mean (SD) 234 (91) compared with 159 (40) minutes), peroperative bleeding (930 (530) ml compared with 350 (180) ml), peroperative transfusions, and the total number of transfusions, so improving the cost:effect ratio of free TRAM breast reconstructions. Microsurgical free TRAM breast reconstructions can be done with good results in peripheral hospitals.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Breast reconstruction with free transverse rectus abdominis myocutaneous flaps in hospitals unaccustomed to microsurgery: Original retrospective study

Salmi¹

2005

Scandinavian Journal of Plastic and Reconstructive Surgery and

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“…Operation times were around five hours in the unilateral cases, which is comparable to times reported elsewhere [1,7,13,17]. Thrombotic complications that threaten the flap and require reoperation develop in less than 5% of patients, the failure rate today being close to zero [18].…”

Section: Discussionmentioning

confidence: 55%

Three-year evaluation of late breast reconstruction with a free transverse rectus abdominis musculocutaneous flap in a county hospital in Sweden: A retrospective study

Olsson

Tukiainen

2005

Scandinavian Journal of Plastic and Reconstructive Surgery and

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We present our three-year experience of late breast reconstruction with conventional free TRAM flaps in 16 consecutive patients in a Swedish county hospital. The breast reconstruction was done unilaterally in 14 and bilaterally in two, giving a total of 18 free TRAM flaps in 16 patients. Six patients developed anastomotic or systemic thromboembolic events during or after the operation' three developed during the operation, and one required reoperation for postoperative thrombosis. No flaps were lost. Three patients developed deep venous thrombosis (DVT) or pulmonary embolism (PE) postoperatively; the two patients with DVT were later found to be resistant to activated protein C. The patient with a PE had developed multiple metastases by one year postoperatively. We compared the six patients who developed anastomotic and systemic thromboembolic events with those whose operations were uncomplicated and no significant differences were found either in their characteristics or overall events during operation.

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“…The problem of vertical, umbilicus-pubic scars can be avoided by lifting the rectus abdominis from both sides and performing a double anastomosis. Even smoking is no longer a contraindication [1] to the use of TRAM, although the rate of complications is higher in heavy smokers.…”

Section: Discussionmentioning

confidence: 99%

Comparison of different techniques in personalized post-mastectomy breast reconstruction

et al. 1994

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Patients undergoing breast reconstruction often ask the plastic surgeon which is the surgical procedure that gives the best results. In order to answer this question, the results of three different techniques of breast reconstruction in 62 cases were compared and evaluated. In 37 cases, the reconstruction was performed by tissue expansion followed by insertion of silicone prostheses (EXP), in 9 cases by a pedicled myocutaneous latissimus dorsi flap with prostheses (LDF), in 16 cases by a microvascular rectus abdominis musculocutaneous flap. Both the subjective (patients' satisfaction and psychological attitude) and the objective data were taken into consideration to evaluate the results. The TRAM results were the best, followed by the EXP technique and then by the LDF technique. The number of immediate and delayed complications was approximately the same using all three techniques, but TRAM is a little safer. Although tissue expansion is the simplest and quickest technique which may be best for some patients, the use of autologous tissue (TRAM) is recommended.

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Experience with 50 Free TRAM Flap Breast Reconstructions

Cited by 91 publications

References 0 publications

Breast reconstruction with free transverse rectus abdominis myocutaneous flaps in hospitals unaccustomed to microsurgery: Original retrospective study

Breast reconstruction with free transverse rectus abdominis myocutaneous flaps in hospitals unaccustomed to microsurgery: Original retrospective study

Three-year evaluation of late breast reconstruction with a free transverse rectus abdominis musculocutaneous flap in a county hospital in Sweden: A retrospective study

Comparison of different techniques in personalized post-mastectomy breast reconstruction

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