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Pedicle tram flap

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https://www.readbyqxmd.com/read/28618735/three-layer-primary-closure-of-the-bipedicled-tram-flap-donor-site-for-unilateralbreast-reconstruction-a-15-year-experience-with-124-consecutive-patients
#1
Hüseyin Karagöz, Cihan Şahin, Celalettin Sever, Yalçın Külahçi, Fikret Eren, Ceyhun Cesur, Fuat Yüksel
BACKGROUND/AIM: The pedicled transverse rectus abdominis myocutaneous (TRAM) flap remains widely used as a breast reconstruction technique. The bipedicled TRAM flap is not as preferable as it was formerly, mainly because of its donor site complications. However, in a number of situations, a bipedicled TRAM flap may be the only alternative. Therefore, a three-layer primary closure technique used with bipedicled TRAM flap breast reconstructions that can avoid donor site complications without using a mesh is presented...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28615830/pedicled-transverse-rectus-abdominis-myocutaneous-flap-a-method-for-tunnelling-with-dilson-luz-vascular-dilation-wands-for-breast-reconstruction
#2
Christopher Tam Song, Joshua Perrett, Terence Goh, Bien Keem Tan
No abstract text is available yet for this article.
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28550924/new-perspective-on-the-in%C3%A2-vivo-use-of-cold-stress-dynamic-thermography-in-integumental-reconstruction-with-the-use-of-skin-muscle-flaps
#3
Szymon Kolacz, Mateusz Moderhak, Jerzy Jankau
BACKGROUND: Among the problems encountered by plastic surgeons is the reconstruction of defects following tumors. One of the reconstructive options is trans rectus abdominis (TRAM) flap. Despite that anatomy is well explored, marginal flap necrosis may develop. To minimize the complications, imaging examinations were designed to determine the degree of flap perfusion. One of them is the thermographic examination. MATERIALS AND METHODS: We examined 38 patients who had undergone 10 reconstructive breast surgeries with a pedicled TRAM ipsilateral flap, 10 patients with a TRAM contralateral flap, and 18 patients with a TRAM supercharged flap...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28536869/the-technique-and-benefits-of-angiographic-embolization-of-inferior-epigastric-arteries-prior-to-pedicled-tram-flap-breast-reconstruction-results-from-a-single-center
#4
Alysse J Sever, Chirag Patel, Yahya Albeer, Vigen B Darian
PURPOSE: To report a single center's experience with selective arterial embolization of the deep inferior epigastric arteries (DIEA) prior to pedicled TRAM flap breast reconstruction including techniques and outcomes. MATERIALS AND METHODS: Retrospective chart review was performed for 15 patients who underwent pedicled TRAM flap breast reconstruction after selective embolization of bilateral DIEA. Data were analyzed to display the spectrum of postoperative outcomes following the TRAM flap procedure status post-selective angiographic embolization of the bilateral DIEA to improve vascularity of the TRAM flaps by rendering the tissue partially ischemic to undergo neovascularization...
May 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28422883/transverse-rectus-abdominis-myocutaneous-flap-for-postpneumonectomy-bronchopleural-fistula-a-case-report
#5
Jen-Wu Huang, Yi-Ying Lin, Nai-Yuan Wu, Chien-Ho Tsai
RATIONALE: Numerous types of flap coverage have been reported to prevent or to repair bronchopleural fistulas. Most of the flaps were harvested from chest area. However, these pedicled flaps might not be optimal for the patient who has undergone previous radiotherapy on pulmonary parenchyma because the pedicle artery of the flap might have been injured by irradiation. Therefore, an alternative flap outside of the chest area is necessary. PATIENT CONCERNS: A 61-year-old male was diagnosed of squamous cell carcinoma in right upper lobe lung (cT3N2M0, stage IIIa)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28277073/enhancement-of-vascular-endothelial-growth-factor-s-angiogenic-capacity-by-the-therapeutic-modulation-of-notch-signalling-improves-tram-flap-survival-in-rats-submitted-to-nicotine
#6
Ozan Luay Abbas, Yunus Kasım Terzi, Orhan Özatik, Fikriye Yasemin Özatik, Gamze Turna, Rukiye Nar, Ahmet Musmul
BACKGROUND: Smoke of cigarettes, and specifically nicotine, has been shown to diminish pedicled transverse rectus abdominis musculocutaneous (TRAM) flap survival. Considering that Notch signalling through its ligand Delta-like 4 (Dll4) functions as anti-angiogenic factor by inhibiting the pro-angiogenic effects of vascular endothelial growth factor (VEGF), it is hypothesised that inhibition of the Notch would promote angiogenesis and increase TRAM flap survival in rats submitted to nicotine...
February 13, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28255154/immediate-simultaneous-bilateral-breast-reconstruction-with-deep-inferior-epigastric-diep-free-flap-and-transverse-rectus-abdominis-musculocutaneous-tram-pedicled-flap
#7
E J Roslan, E G Kelly, M A Zain, N H Basiron, F H Imran
Breast reconstructive surgery has evolved tremendously since its inception. Following tumour clearance surgery, physical restoration with breast reconstruction is an important aspect of physical and emotional rehabilitation. Various methods have been described to suit patients demand for the best aesthetic outcome. Surgeon's preference, experience and practicality of differing procedures must be considered. We describe a simultaneous bilateral breast reconstruction with free deep inferior epigastric (DIEP) flap and pedicled transverse rectus abdominis musculocutaneous (TRAM) flap immediately post mastectomies for bilateral breast cancers...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#8
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28052051/deep-inferior-epigastric-perforator-versus-free-transverse-rectus-abdominis-myocutaneous-flap-complications-and-resource-utilization
#9
Yasmina Zoghbi, David J Gerth, Jun Tashiro, Samuel Golpanian, Seth R Thaller
INTRODUCTION: Abdominal based breast reconstruction exists in a continuum from pedicled transverse rectus abdominis myocutaneous (TRAM) flap to deep inferior epigastric perforator (DIEP) free flap. DIEP flap has the advantage of complete rectus abdominis sparing during harvest, thus decreasing donor site morbidity. Aim of this study is to determine whether the surgical advantages of the DIEP flap impact postoperative outcomes versus the free TRAM flap (fTRAM). METHODS: We reviewed the Nationwide Inpatient Sample database (2010-2011) for all cases of DIEP and fTRAM breast reconstruction...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27798424/considering-the-optimal-timing-of-breast-reconstruction-with-abdominal-flaps-with-adjuvant-irradiation-in-370-consecutive-pedicled-transverse-rectus-abdominis-myocutaneous-flap-and-free-deep-inferior-epigastric-perforator-flap-performed-in-a-chinese-oncology
#10
Shanshan He, Jian Yin, Geoffrey L Robb, Jingyan Sun, Xuehui Zhang, Haixin Li, Jing Liu, Chunyong Han
PURPOSE: There is an ongoing debate on the optimal sequence of radiation and breast reconstruction. The purpose of this article was to (a) assess the impact of radiation on autologous breast reconstruction and (b) analyze the best timing for autologous breast reconstruction in the setting of radiation in a Chinese population. METHODS: A retrospective review of patients undergoing breast reconstruction with autologous lower abdominal flaps between 2001 and 2014 in the Tianjin Medical University and Cancer Hospital was performed...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27785362/low-intensity-pulsed-ultrasound-stimulation-in-different-regions-in-the-viability-of-myocutaneous-flaps
#11
Fernanda Luiza de Almeida Albuquerque, Lais Mara Siqueira das Neves, Elaine Caldeira de Oliveira Guirro
BACKGROUND: Low-intensity pulsed ultrasound (LIPUS) has presented good results in the healing of chronic wounds. The objective of this study was to compare the effect of LIPUS on the viability of transverse rectus abdominal muscle (TRAM) flap in different regions (central and epigastric) in rats. METHODS: Twenty-one Wistar male rats were homogeneously distributed into three groups as follows: group 1 (control), animals submitted to surgery only; group 2, animals submitted to surgery and application of LIPUS at the center of the flap; and group 3, animals submitted to surgery and application of LIPUS at the flap area corresponding to the right inferior epigastric artery pedicle...
2016: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/27757337/abdominal-closure-after-tram-flap-breast-reconstruction-with-transversus-abdominis-muscle-release-and-mesh
#12
Antonio Espinosa-de-Los-Monteros, Héctor Avendano-Peza, Yuri W Novitsky
Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction...
September 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27743083/free-versus-pedicled-tram-flaps-cost-utilization-and-complications
#13
Samuel Golpanian, David J Gerth, Jun Tashiro, Seth R Thaller
INTRODUCTION: Conventionally, free transverse rectus abdominis myocutaneous (fTRAM) flap breast reconstruction has been associated with decreased donor site morbidity and improved flap inset. However, clinical success depends upon more sophisticated technical expertise and facilities. This study aims to characterize postoperative outcomes undergoing free versus pedicled TRAM (pTRAM) flap breast reconstruction. METHODS: Nationwide inpatient sample database (2008-2011) was reviewed for cases of fTRAM (ICD-9-CM 85...
December 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27704608/direct-thrombectomy-as-a-salvage-technique-in-free-flap-breast-reconstruction
#14
Ki Yong Hong, Lan Sook Chang, Hak Chang, Kyung Won Minn, Ung Sik Jin
BACKGROUND: Breast reconstruction with microvascular free tissue transfer has become a widely used method. Despite a high rate of success, a compromised flap necessitating re-exploration can occur. Here, we introduce direct thrombectomy as a flap salvage technique, and compared the results with conventional thrombectomy. METHODS: A total of 488 patients who underwent breast reconstruction using a free transverse rectus abdominis myocutaneous flap between March 2009 and February 2014 were retrospectively analyzed...
October 5, 2016: Microsurgery
https://www.readbyqxmd.com/read/27633564/effect-of-fibrin-sealant-in-positioning-and-stabilizing-microvascular-pedicle-a-comparative-study
#15
Jeong Tae Kim, Youn Hwan Kim, Sang Wha Kim
INTRODUCTION: Fibrin sealants have had applications in hemostasis, cohesion, and promotion of healing in plastic surgery. In this article, we review cases where fibrin sealant was used to stabilize microvascular pedicles and compared with previous free flaps performed without fibrin sealant. METHODS: Between 2008 and 2010, 62 consecutive patients underwent free tissue transfer for reconstruction; this involved 33 latissimus dorsi perforator flaps, 14 thoracodorsal artery perforator flaps, 9 latissimus dorsi myocutaneous flaps, 3 lateral thoracic artery perforator flaps, and 3 transverse rectus abdominis myocutaneous flaps, used in head and neck reconstruction, lower limb reconstructions, breast reconstructions, and facial palsy reconstruction...
September 16, 2016: Microsurgery
https://www.readbyqxmd.com/read/27563562/complications-and-oncologic-outcomes-of-pedicled-transverse-rectus-abdominis-myocutaneous-flap-in-breast-cancer-patients
#16
Prakasit Chirappapha, Ongart Somintara, Panuwat Lertsithichai, Youwanush Kongdan, Chairat Supsamutchai, Rupporn Sukpanich
BACKGROUND: There are several techniques for harvesting the pedicled transverse rectus abdominis myocutaneous (TRAM) flap after mastectomy in breast cancer patients. We examined the whole muscle with partial sheath sparing technique and determined factors associated with its complications and oncological outcomes. METHODS: We retrospectively reviewed the results of 168 TRAM flaps performed between January 2003 and December 2010, focusing on complications and oncologic outcomes...
August 2016: Gland Surgery
https://www.readbyqxmd.com/read/27537823/chylous-ascites-after-pedicled-transverse-rectus-abdominis-myocutaneous-flap-harvest
#17
Chin-Ta Lin, Tim-Mo Chen
Chylous ascites is a rare clinical condition that occurs as a consequence of disruption of the abdominal lymphatics. Here, we present the case of a 58-year-old woman with sustained chylous ascites after pedicled transverse rectus abdominis myocutaneous (TRAM) flap harvest. The chylous ascites did not decrease despite conservative therapy. For the diagnosis and localization of the chyle leakage, lymphangiography with lipiodol delivery was performed. Chylous drainage continued in a decreasing manner for the next 4 d because lipiodol accumulated to the point of leakage outside the lymphatic vessel causing a regional inflammatory reaction and obstructing the lymphatic vessels...
August 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27406872/breast-reconstruction-with-single-pedicle-tram-flap-in-breast-cancer-patients-with-low-midline-abdominal-scar
#18
Jun-Dong Wu, Wen-He Huang, Si-Qi Qiu, Li-Fang He, Cui-Ping Guo, Yong-Qu Zhang, Fan Zhang, Guo-Jun Zhang
Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is challenging in patients with low midline abdominal scar. In this study, we aimed to investigate the clinical feasibility of immediate breast reconstruction using single-pedicle TRAM (SP-TRAM) flaps in patients with low midline abdominal scar. There were 4 strict selection criteria: 1) presence at least 3 perforators on the pedicle side; 2) perforators with regional average flow velocity of >20 cm/s; 3) upper edge of the abdominal scar at least 4 cm from the umbilicus; and 4) scar age >1 year...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27121604/risk-factors-of-mastectomy-skin-flap-necrosis-in-immediate-breast-reconstruction-using-low-abdominal-flaps
#19
Taik Jong Lee, Tae Suk Oh, Eun Key Kim, Hyunsuk Suh, Sei Hyun Ahn, Byung Ho Son, Jong Won Lee, Jonghan Cho, Jin Sup Eom
BACKGROUND: The purpose of this study was to determine the risk factors associated with mastectomy skin flap necrosis during immediate reconstruction with TRAM or DIEP flaps. METHODS: This study reviewed 1116 cases of immediate breast reconstruction over 10 years. Patients ranged in age from 29-76 years (average = 45.1 years), and had an average follow-up period of 65.6 months. Thirteen factors (age, BMI (body mass index), smoking habits, diabetes ptosis grade, midclavicle-to-nipple distance, neoadjuvant chemotherapy, free or pedicled flap, mastectomy method, surgeon, stage, axillary dissection, mastectomy weight) known to be associated with mastectomy flap necrosis were retrospectively analysed...
October 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27119911/dual-pedicle-flap-for-unilateral-autologous-breast-reconstruction-revisited-evolution-and-optimization-of-flap-design-over-15-years
#20
Edward I Chang, Steven J Kronowitz
BACKGROUND: In thin patients or when a significant amount of skin is needed, use of the entire abdomen to reconstruct a single breast may be necessary. In this article, the authors present their 15-year experience in dual-pedicle flap evolution and optimization of flap design. METHODS: A retrospective review was conducted of all bipedicle flaps performed from 2000 to 2015. RESULTS: Overall, 57 patients (mean age, 49.2 years; mean body mass index, 26...
May 2016: Plastic and Reconstructive Surgery
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