Minimizing donor-site morbidity following bilateral pedicled TRAM breast reconstruction with the double mesh fold over technique

Ann Plast Surg. 2013 May;70(5):484-7. doi: 10.1097/SAP.0b013e31828569c0.

Abstract

Introduction: Transverse rectus abdominus muscle flaps (TRAM) can result in significant abdominal wall donor-site morbidity. We present our experience with bilateral pedicle TRAM breast reconstruction using a double-layered polypropylene mesh fold over technique to repair the rectus fascia.

Methods: A retrospective study was performed that included patients with bilateral pedicle TRAM breast reconstruction and abdominal reconstruction using a double-layered polypropylene mesh fold over technique.

Results: Thirty-five patients met the study criteria with a mean age of 49 years old and mean follow-up of 7.4 years. There were no instances of abdominal hernia and only 2 cases (5.7%) of abdominal bulge. Other abdominal complications included partial umbilical necrosis (14.3%), seroma (11.4%), partial wound dehiscence (8.6%), abdominal weakness (5.7%), abdominal laxity (2.9%), and hematoma (2.9%).

Conclusions: The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Mammaplasty / instrumentation
  • Mammaplasty / methods*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Postoperative Complications / epidemiology
  • Rectus Abdominis / surgery*
  • Retrospective Studies
  • Surgical Flaps*
  • Surgical Mesh*