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Pedicle tram flap surgery

Mark M Leyngold
BACKGROUND: Pedicled transverse rectus abdominis myocutaneous (TRAM) flap was developed by Hartrampf in 1982 for breast reconstruction. Since deep inferior epigastric perforator (DIEP) flap was popularized, it has become the criterion standard for abdominally based breast reconstruction owing to its low donor site morbidity, excellent cosmetic outcomes, and high success rates. The purpose of this review is to determine if a unilateral pedicle TRAM flap has become obsolete to DIEP flap...
June 2018: Annals of Plastic Surgery
Chenyang Ji, Ruiting Li, Grace Shen, Jinming Zhang, Weiqiang Liang
Large defects after skin malignant tumors resection were difficult to repair. We introduced a partition concept, in which the large defects were divided into several subunits, and each subunit was repaired by a certain pedicled flap to achieve a complete coverage.Between May 2012 and Oct 2016, 8 patients with skin malignant tumors underwent radical resection. Prior to surgery, the dimension of the potential defect after tumor ablation was estimated and outlined. After evaluation, the partition concept was applied and the defects were divided into several subunits...
July 2017: Medicine (Baltimore)
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
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)
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...
December 2017: Journal of Plastic Surgery and Hand Surgery
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
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
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
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...
July 2017: Microsurgery
Murat Gorkem Ataman, Cagri A Uysal, Nilgun Markal Ertas, Nilufer Bayraktar, Aysen Terzi, Huseyin Borman
BACKGROUND: Transverse rectus abdominis musculocutaneous (TRAM) flap is one of the options in reconstruction after breast cancer surgery for breast reconstruction. Tissue necrosis often occurs in the third and fourth perfusion zones of the flap. A study was planned to find out the effects of adipose stromal vascular fraction (SVF) cells on viability of TRAM flap and the experimental model was designed to be applicable in clinical practice. METHODS: Right inferior epigastric artery pedicled, 5 × 2...
October 2016: Journal of Plastic Surgery and Hand Surgery
Hung-Wen Lai, Shou-Tung Chen, Dar-Ren Chen, Shu-Ling Chen, Tsai-Wang Chang, Shou-Jen Kuo, Yao-Lung Kuo, Chin-Sheng Hung
BACKGROUND: Endoscopy-assisted breast surgery (EABS) performed through minimal axillary and/or periareolar incisions is a possible alternative to open surgery for certain patients with breast cancer. In this study, we report the early results of an EABS program in Taiwan. METHODS: The medical records of patients who underwent EABS for breast cancer during the period May 2009 to December 2014 were collected from the Taiwan Endoscopic Breast Surgery Cooperative Group database...
2016: PloS One
Valeriy Shubinets, Justin P Fox, Jonathan R Sarik, Stephen J Kovach, John P Fischer
BACKGROUND: Donor-site hernia is one of the most feared complications following abdominally based autologous breast reconstruction. The authors aim to assess the incidence of surgically repaired abdominal hernia across different types of abdominally based breast reconstruction, identify predictive perioperative factors, and estimate the health care charges associated with this morbidity. METHODS: Using inpatient and ambulatory surgery data from four states in the United States, the authors identified adult women who underwent pedicled transverse rectus abdominis muscle (TRAM), free TRAM, or deep inferior epigastric perforator (DIEP) flap breast reconstruction between 2008 and 2012...
March 2016: Plastic and Reconstructive Surgery
Kai Yang, Lan Mu, Yan Liu, Zhe Peng, Guangxue Li
OBJECTIVE: To investigate the utility of indocyanine green angiography in flap reconstructive surgery and possibility of decrease the complications. METHODS: Indocyanine green angiography was performed on 14 patients undergoing flap reconstructive surgery between February and December 2014 to evaluate the blood perfusion of the flap and to adjust the operation plan. Of 14 cases, 2 were male and 12 were female, aged 23-58 years (mean, 35.5 years); 11 flaps were used for breast reconstruction [including 3 free deep inferior epigastric antery perforator (DIEP) flaps, 4 pedicled transverse rectus abdominis myocutaneous flaps (TRAM), 2 pedicled TRAM and free TRAM, and 2 pedicled latissimus dorsi myocutaneous flaps and prosthesis], 1 pedicled latissimus dorsi myocutaneous flap for repairing chest wall defect, 1 pedicled profunda artery perforator (PAP) flap for upper leg defect, and 1 pedicled descending genicular artery perforator flap for knee defect...
September 2015: Chinese Journal of Reparative and Reconstructive Surgery
Sadaf Alipour, Ramesh Omranipour, Rahim Akrami
Transverse rectus abdominis musculocutaneous (TRAM) flap is the most common procedure performed for breast reconstruction after mastectomy for breast cancer. Obesity is a relative contraindication, and complex modifications have been proposed in the pedicled technique for obese patients. We studied ischemic complications in our patients to investigate the effect of body weight on the outcome of TRAM flap breast reconstruction. Pertinent data from medical records of patients receiving a TRAM flap surgery from 1986 to 2011 were extracted...
December 2015: Indian Journal of Surgery
Sophocles H Voineskos, Simon G Frank, Peter G Cordeiro
Breast reconstruction can be performed using a variety of techniques, most commonly categorized into an alloplastic approach or an autologous tissue method. Both strategies have certain risk factors that influence reconstructive outcomes and complication rates. In alloplastic breast reconstruction, surgical outcomes and complication rates are negatively impacted by radiation, smoking, increased body mass index (BMI), hypertension, and prior breast conserving therapy. Surgical factors such as the type of implant material, undergoing immediate breast reconstruction, and the use of fat grafting can improve patient satisfaction and aesthetic outcomes...
December 2015: Gland Surgery
Benlong Yang, Lin Li, Wenhui Yan, Jiaying Chen, Ying Chen, Zhen Hu, Guangyu Liu, Zhenzhou Shen, Zhimin Shao, Jiong Wu
BACKGROUND: The goal of this study was to evaluate patient satisfaction with four common types of breast reconstruction performed at our institution: latissimus dorsi myocutaneous (LDM) flap reconstruction with or without implants, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, and free deep inferior epigastric perforator (DIEP) flap reconstruction. METHODS: A custom survey consisting of questions that assessed general and aesthetic satisfaction was sent to patients who had undergone breast reconstruction in the last 5 years...
2015: PloS One
Ji Hong Yim, Taik Jong Lee
BACKGROUND: The inverted nipple is a relatively common aesthetic problem seen by plastic surgeons. The etiologies of an inverted nipple include insufficiency of supporting tissues, hypoplasia of the lactiferous ducts, and retraction caused by fibrous bands at the base of the nipple. Many different surgical techniques have been described, either individually or in combination, but none represents a landmark strategy. In our present study, we report our experience of spontaneous improvement immediately after nipple-sparing mastectomy with simple buried interrupted sutures to maintain nipple base in inverted nipple patients...
August 2016: Annals of Plastic Surgery
Benjamin B Massenburg, Paymon Sanati-Mehrizy, Michael J Ingargiola, Jonatan Hernandez Rosa, Peter J Taub
PURPOSE: There are many options for breast reconstruction following a mastectomy, and data on outcomes are greatly needed for both the patient and the care provider. This study aims to identify the prevalence and predictors of adverse outcomes in autologous breast reconstruction in order to better inform patients and surgeons when choosing a surgical technique. METHODS: This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified each autologous breast reconstruction performed between 2005 and 2012...
December 2015: Aesthetic Plastic Surgery
Chen Jia-jian, Huang Nai-si, Xue Jing-yan, Yang Ben-long, Liu Guang-yu, Di Gen-hong, Shao Zhi-min, Wu Jiong
The study of this study is to assess the current status and trend of the application of breast reconstruction in China.A retrospective review of all patients who had received surgical treatment for breast cancer in the Fudan University Shanghai Cancer Center between January 1999 and June 2014 was performed. The clinicopathological and epidemiological parameters and the follow-up information of each patient were collected.A total of 20,551 patients with 20,974 surgeries were identified. Of those, the rates of patients received mastectomy, breast conserving therapy, and breast reconstruction were 81...
August 2015: Medicine (Baltimore)
Aaron D C Knox, Adelyn L Ho, Leslie Leung, A Yashar Tashakkor, Peter A Lennox, Nancy Van Laeken, Sheina A Macadam
BACKGROUND: There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery related to abdominal morbidity, operative time, and complications. METHODS: This is a retrospective review of patients undergoing breast reconstruction using the DIEP or pTRAM flap at the University of British Columbia between 2002 and 2013...
July 2016: Plastic and Reconstructive Surgery
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