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Muscle sparing-2 transverse rectus abdominis musculocutaneous flap for breast reconstruction: A comparison with deep inferior epigastric perforator flap

✍ Scribed by Meisei Takeishi; Masashi Fujimoto; Katuhiro Ishida; Yojiro Makino


Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
182 KB
Volume
28
Category
Article
ISSN
0738-1085

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✦ Synopsis


Abstract

Breast reconstruction using free transverse rectus abdominis musculocutaneous (TRAM) flap can be divided into 4 muscle‐sparing (MS) types: conventional TRAM flap containing full width muscle as MS‐0, while deep inferior epigastric perforator (DIEP) flap containing absolutely no muscle as MS‐3. We include only the muscle portion between the medial row and lateral row perforator vessels in TRAM flap, which is designated as MS‐2. Between October 1999 and April 2006, the same surgeon performed 82 breast constructions using MS‐2 free TRAM flaps in 79 patients. All the flaps survived. Postoperative complications included partial fat necrosis in 8 cases, all corresponding to zone IV or zone II. Bulging of donor site occurred in 5 patients, 4 of whom were obese and 1 had bilateral flap harvest. Compared with our own reconstructions using DIEP flap (30 cases), there were no significant differences in operative time and blood loss between the two techniques. In conclusion, MS‐2 free TRAM flap is a useful technique for breast construction considering the easy surgical techniques, length of the vascular pedicle that can be harvested, and the degree of freedom of the flap. © 2008 Wiley‐Liss, Inc. Microsurgery, 2008.


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## Abstract Despite the sacrifice of rectus abdominis muscle, the vertical rectus abdominis musculocutaneous (VRAM) flap is still a preferred option for perineal reconstruction. This journal has previously reported on the utility of preoperative computed tomographic angiography (CTA) in this settin