"TRAM" FLAB IN POSTMASTECTOMY RECONSTRUCTION

Abstract

During the last decade, general trend in breast reconstruction has been towards the employment of autogenous tissues. For this purpose, rectus abdominis musculocutaneous flap with a transverse skin island (TRAM) has been used with an increasing frequency and has proved to be a reliable method of reconstruction. In this series, the TRAM flap was used for breast reconstruction in 6 patients which include 5 postmastectomy cases and 1 severe breast asymmetry due to a skin infection during childhood. In all cases, delayed reconstruction was performed with the time elapsed after mastectomy being between 15 months-7 years. In 2 patients, partial skin necrosis at the tip of the random portion of the Hap was observed together with a limited fat necrosis in öne of the cases. Abdominal wall hernia occurred in 1 patient. This was repaired with a free fascia lata graft at a later date. Neither the skin nor the fat necrosis necessitated any debridement and all healed well with secondary intention leaving inconspicous scars. In all cases, the aesthetic results obtained were found to be satisfactory. Considering that the TRAM flap provides sufficient bulk of skin and subcutaneous tissue, there by obviating the need for a prosthesis; has a reliable vasculature, and provides a special bonus of an incidental abdominoplasty, it was regarded to be a versatile flap in breast reconstruction.