OBJECTIVETo evaluate the early outcomes of breast reconstruction with free transverse rectus abdominis myocutaneous (TRAM) flaps after resection of breast cancer.

METHODSA total of 12 free TRAM flaps were performed after breast cancer surgery in The University of Texas Health Science Center at San Antonio from July 2003 to November 2003. Average patient age was 43.5 years, and average weight was 68.6 kg. Reconstruction was undertaken as an immediate procedure after mastectomy in two patients (16.7%) and as a delayed procedure in 10 patients (83.3%). The flap was harvested based on the deep inferior epigastric vessel on the opposite side to the affected breast. Of the 12 patients, 2 patients underwent reconstruction using the thoracodorsal vessels and 10 patients underwent reconstruction using the internal mammary vessels as the receipt vessels. Mean follow-up time was 2.8 months. The surgical technique, complications and the early results of breast reconstruction are reported.

RESULTSThe free TRAM flap Reconstruction was successfully performed in all patients at a success rate of 100% . Average operating time was 495 minutes, and average hospital stay was 9.4 days. The contralateral breast reduction was performed in 5 (41.7%) of the patients. Six complications occurred in 3 of 12 reconstructions (25%). Complications included three haematoma or seroma formation, two delayed wound healing and one partial fat necrosis. There were no major postoperative complications such as partial flap loss, total flap loss, wound infection or abdominal wall hernia. RESULTS were considered extremely satisfactory or satisfactory in 11 cases (91.7%), less satisfactory in one case (8.3%). No case was dissatisfied with her reconstruction. Conclusions This study suggests that the free TRAM flap for breast reconstruction is a safe and reliable technique which provides an excellent cosmetic outcome with a high degree of patient satisfaction.