Minimizing Donor-Site Morbidity Following Bilateral Pedicled TRAM Breast Reconstruction With the Double Mesh Fold Over Technique

作者：Bharti Gaurav; Groves Leslie; Sanger Claire; Thompson James; David Lisa; Marks Malcolm^*

来源：Annals of Plastic Surgery, 2013, 70(5): 484-487.

DOI：10.1097/SAP.0b013e31828569c0

• anterior rectus fascia
• transverse rectus abdominus muscle flaps
• polypropylene mesh
• abdominal reconstruction

Introduction: Transverse rectus abdominus muscle flaps (TRAM) can result in significant abdominal wall donor-site morbidity. We present our experience with bilateral pedicle TRAM breast reconstruction using a double-layered polypropylene mesh fold over technique to repair the rectus fascia.
Methods: A retrospective study was performed that included patients with bilateral pedicle TRAM breast reconstruction and abdominal reconstruction using a double-layered polypropylene mesh fold over technique.
Results: Thirty-five patients met the study criteria with a mean age of 49 years old and mean follow-up of 7.4 years. There were no instances of abdominal hernia and only 2 cases (5.7%) of abdominal bulge. Other abdominal complications included partial umbilical necrosis (14.3%), seroma (11.4%), partial wound dehiscence (8.6%), abdominal weakness (5.7%), abdominal laxity (2.9%), and hematoma (2.9%).
Conclusions: The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia.

• 出版日期2013-5