AAPS Main Site  |  Past & Future Meetings
American Association of Plastic Surgeons
11. A Review of 110 Consecutive Muscle Sparing Free TRAMs for Breast Reconstruction: A Recent Series By a Single Surgeon
L. F. Elliott, MD1, Hisham Seify, MD2.
1Atlanta Plastic Surgery, Atlanta, GA, USA, 2Emory University, Atlanta, GA, USA.

Purpose:
The purpose of this study to examine a recent consecutive series of 110 free TRAMs for breast reconstruction performed by a single surgeon in a private practice setting. These were TRAMs performed between 2001 and 2003. It is rare for any TRAM series to be by a single surgeon with a large volume in recent years only. This represents a current “snapshot “and perhaps a current indication of the state of TRAM performance today.
Methods:
Data was reviewed retrospectively and included patient demographics, operative time, and choice of recipient vessel, contralateral breast as well as outcome, patient satisfaction and peri-operative morbidities.
Results:
One hundred patients underwent free TRAM flap for breast reconstruction (88 immediate, 12 patients delayed).IMA was used in 74 cases, thoracodorsal in 36 cases. Average operative time was 185 minutes ( 3 hours), average blood loss was 195 cc. Thirteen patients (13%) required mesh for abdominal wall closure. Sixteen patients (16%) had fat necrosis. Revision of the micro vascular anastomosis was performed in 4 patients with flap salvage in all of them. Two patients had hematoma that required surgical evacuation. Abdominal wall hernia was detected in two patients (2%) and required subsequent mesh repair.
Conclusion:
The muscle sparing free TRAM flap has become a reliable technique for breast reconstruction. This study presents recent data for the performance of this procedure by a single surgeon in the private practice setting. The technical difficulties associated with the procedure are overcome using a well designed intra-operative algorithm together with a team familiar with the procedure.


Back to Program Outline