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.

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.
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.
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.
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