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Pedicle tram flap surgery

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...
October 28, 2016: 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...
September 16, 2016: 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
Joanna C Mennie, Pari-Naz Mohanna, Joe M O'Donoghue, Richard Rainsbury, David A Cromwell
BACKGROUND: The authors investigated hernia repair rates following pedicled transverse rectus abdominis myocutaneous (TRAM), free TRAM, and deep inferior epigastric perforator (DIEP) flap breast reconstruction in English National Health Service hospitals. METHODS: Women diagnosed with breast cancer who underwent pedicled TRAM, free TRAM, or DIEP flap breast reconstruction procedures in English National Health Service hospitals between April of 2006 and March of 2012 were identified using the Hospital Episode Statistics database...
July 2015: Plastic and Reconstructive Surgery
Ying Chen, Jiajian Chen, Jiaying Chen, Benlong Yang, Lin Li, Xiaoyan Huang, Zhimin Shao, Zhenzhou Shen, Peirong Yu, Jiong Wu
OBJECTIVE: To explore the current trends of breast reconstruction (BR) for breast cancer patients in China. METHODS: A questionnaire was designed for this study, and it included questions on surgeon demographics, number of mastectomy and BR, type and timing of BR, reconstructive choices in the setting of preoperative or postoperative radiotherapy or chemotherapy, etc. All data were collected until December 2012. Questionnaires were sent to 52 members of the Committee of Breast Cancer Society by e-mail or mail...
November 2014: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Anaeze C Offodile, Holly Prigerson, Randall O Craft, Allen Liu, Lifei Guo
BACKGROUND: There is little data examining the psychosocial characteristics of women who choose a type of autologous postmastectomy reconstruction. This study sought to investigate the role of personality on decision making and postoperative satisfaction in autologous breast reconstruction. PATIENTS AND METHODS: A retrospective survey of 120 consecutive patients who had undergone transverse rectus abdominis myocutaneous (TRAM) or perforator flap (PF) reconstruction over a 4-year period by a single surgeon at a single academic institution...
February 2015: Journal of Reconstructive Microsurgery
Hossein Masoomi, Garrett A Wirth, Keyianoosh Z Paydar, Brandon K Richland, Gregory R D Evans
BACKGROUND: The aims of this study were (1) to evaluate the frequency of various reconstructive techniques for autologous breast reconstruction and (2) to compare perioperative outcomes of autologous breast reconstruction in teaching versus nonteaching hospitals. MATERIALS: The authors analyzed clinical data of patients who underwent autologous breast reconstructive surgery from 2009 to 2010 using the Nationwide Inpatient Sample database. Autologous breast reconstruction operations included latissimus dorsi myocutaneous, pedicled transverse rectus abdominis myocutaneous (TRAM), free TRAM, free deep inferior epigastric artery perforator (DIEP), free superficial inferior epigastric artery, and free gluteal artery perforator flaps...
October 2014: Plastic and Reconstructive Surgery
Magdalena Graczyk, Justyna Kostro, Jerzy Jankau, Justyna Bigda, Andrzej Skorek
The number of breast reconstruction procedures has been increasing in recent years. One of the suggested treatment methods is breast reconstruction with a pedicled skin and muscle TRAM flap (transverse rectus abdominis muscle - TRAM). Surgical incisions performed during a cholecystectomy procedure may be located in the areas significant for flap survival. The aim of this paper is to present anatomical changes in abdominal walls secondary to pedicled skin and muscle (TRAM) flap breast reconstruction, which influence the planned access in cholecystectomy procedures...
September 2014: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Hung-Wen Lai, Hurng-Sheng Wu, Kun-Lin Chuang, Dar-Ren Chen, Tsai-Wang Chang, Shou-Jen Kuo, Shou-Tung Chen, Yao-Lung Kuo
BACKGROUND: Endoscopy-assisted breast surgery performed through minimal axillary and/or periareolar incisions is a viable option for patients with breast cancer. In this study, we report the preliminary results of patients with breast cancer who underwent endoscopy-assisted total mastectomy (EATM) followed immediately by pedicled transverse abdominis musculocutaneous (TRAM) flap reconstruction. METHODS: Patients in this study comprised women with breast cancer who received EATM and pedicled TRAM flap reconstruction...
August 2015: Surgical Innovation
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