Simplified Insetting Strategy in Pedicled TRAM Flap Breast Reconstruction.
- Author:
Taik Jong LEE
1
;
Sang Yub YOON
Author Information
1. Asan Medical Center, Department of Plastic Surgery, University of Ulsan, College of Medicine, Seoul, Korea. tjlee@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Transverse rectus abdominis myocutaneous flap;
Breast reconstruction
- MeSH:
Asian Continental Ancestry Group;
Breast*;
Fat Necrosis;
Female;
Humans;
Mammaplasty*;
Myocutaneous Flap;
Rectus Abdominis
- From:Journal of the Korean Society of Plastic and Reconstructive Surgeons
2006;33(3):298-302
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Various method of insetting the transverse rectus abdominis myocutaneous flap for breast reconstruction has been reported in literature. The Bostwick's principle is commonly applied, which utilizes contralateral pedicle in a vertical or oblique flap inset position and ipsilateral pedicle in the transverse position. But it is relatively a complex and difficult technique, thus requires a more simplified strategy. We have formulated a new insetting method, in which the contralateral pedicled TRAM flap with an oblique(0 degree - 90 degrees) flap inset was carried out. We used this method in 100 cases from July 2001 to June 2003. This maneuver places Hartrampf's zones I and III with good vascularity in the medial side, and zone II in lateral side of breast. Fat necrosis was observed in 14 patients(14%) and of these, only three cases needed surgical excision. This simplified method is easy to learn. Specifically, fat necrosis removal is easy with more tolerable aesthetic results, especially in Asian patients with smaller breasts.
