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https://www.readbyqxmd.com/read/29134158/a-quick-evaluation-of-tram-flap-viability-using-fingerstall-type-tissue-oximetry
#1
Itaru Tsuge, Tatsuki Enoshiri, Susumu Saito, Shigehiko Suzuki
Supplemental Digital Content is available in the text.
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29068921/evidence-based-clinical-practice-guideline-autologous-breast-reconstruction-with-diep-or-pedicled-tram-abdominal-flaps
#2
COMPARATIVE STUDY
Bernard T Lee, Jayant P Agarwal, Jeffrey A Ascherman, Stephanie A Caterson, Diedra D Gray, Scott T Hollenbeck, Seema A Khan, Lauren D Loeding, Raman C Mahabir, Archibald S Miller, Galen Perdikis, Jaime S Schwartz, Beth A Sieling, Achilles Thoma, Judith A Wolfman, Jean L Wright
The American Society of Plastic Surgeons commissioned a multistakeholder Work Group to develop recommendations for autologous breast reconstruction with abdominal flaps. A systematic literature review was performed and a stringent appraisal process was used to rate the quality of relevant scientific research. The Work Group assigned to draft this guideline was unable to find evidence of superiority of one technique over the other (deep inferior epigastric perforator versus pedicled transverse rectus abdominis musculocutaneous flap) in autologous tissue reconstruction of the breast after mastectomy...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29046098/infection-of-ptfe-mesh-15-years-following-pedicled-tram-flap-breast-reconstruction-mechanism-and-aetiology
#3
A Elfaki, A Gkorila, M Khatib, C M Malata
The pedicled transverse rectus abdominis myocutaneous (TRAM) flap procedure is still widely used for breast reconstruction. The repair of the flap harvest site in the transverse rectus abdominis muscle and sheath is often assisted by the use of prosthetic meshes. This decreases the risk of abdominal wall weakness and herniation but, being a foreign body, it also carries the risk of infection. In this report, we describe the case of a 63-year-old patient who, whilst receiving chemotherapy for metastatic breast cancer, presented with an infected polytetrafluoroethylene mesh 15 years after pedicled TRAM flap immediate breast reconstruction...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29019862/complications-and-patient-reported-outcomes-after-abdominal-based-breast-reconstruction-results-of-the-mastectomy-reconstruction-outcomes-consortium-mroc-study
#4
Jessica Erdmann-Sager, Edwin G Wilkins, Andrea L Pusic, Ji Qi, Jennifer B Hamill, Hyungjin Myra Kim, Gretchen E Guldbrandsen, Yoon S Chun
BACKGROUND: Abdominal flap reconstruction is the most popular form of autologous breast reconstruction. The current study compared complications and patient-reported outcomes (PROs) after pedicled transverse rectus abdominis myocutaneous (PTRAM), free TRAM (FTRAM), deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) flaps. METHODS: Patients having abdominal-based breast reconstruction at 11 centers were prospectively evaluated for abdominal donor-site and breast complications...
October 10, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28856027/cutaneous-erythema-at-scar-site-of-modified-radical-mastectomy-an-unexpected-manifestation-of-recurrent-carcinoma
#5
Awrad Mohammed-Reda Nasralla, Mohammed Abdulirazzaq Al-Duhileb, Ali Jamal-Aldein Arini, Samir Sami Amr
A 44-year-old woman presented with marked erythema over right mastectomy scar, while on Herceptin therapy. She had neoadjuvant chemotherapy, modified radical mastectomy, and radiotherapy less than one year earlier for the treatment of invasive ductal carcinoma. On physical examination, no palpable masses were detected in the erythematous skin. A biopsy revealed permeation of the skin lymphatics by emboli of metastatic ductal carcinoma, similar to what is seen in inflammatory carcinoma. The involved skin was excised, followed by immediate reconstruction with transverse rectus abdominis muscle (TRAM) flap...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28833134/changes-in-shoulder-muscle-activity-pattern-on-surface-electromyography-after-breast-cancer-surgery
#6
Eun Joo Yang, YoungOk Kwon
BACKGROUND AND OBJECTIVES: Alterations in muscle activation and restricted shoulder mobility, which are common in breast cancer patients, have been found to affect upper limb function. The purpose of this study was to determine muscle activity patterns, and to compare the prevalence of abnormal patterns among the type of breast surgery. METHODS: In total, 274 breast cancer patients were recruited after surgery. Type of breast surgery was divided into mastectomy without reconstruction (Mastectomy), reconstruction with tissue expander/implant (TEI), latissimus dorsi (LD) flap, or transverse rectus abdominis flap (TRAM)...
August 22, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28822648/cyclooxygenase-2-inhibitors-and-free-flap-complications-after-autologous-breast-reconstruction-a-retrospective-cohort-study
#7
Christian Bonde, Hoda Khorasani, Jens Hoejvig, Henrik Kehlet
BACKGROUND: A key component of modern analgesics is the use of multimodal opioid-sparing analgesia (MOSA). In the past, our analgesic regime after autologous breast reconstruction (ABR) included either NSAID or a selective cyclooxygenase-2 (COX-2) inhibitor. COX-2 inhibitors are superior to NSAIDs because of the well-known side effects of NSAID treatment (bleeding/gastrointestinal ulcers). However, COX-2 inhibitors have been suggested to increase flap failure rates. We report our experience in using COX-2 inhibitors as part of our post-operative MOSA after ABR using free flaps...
November 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28806290/-clinical-and-quantitative-isokinetic-comparison-of-abdominal-morbidity-and-dynamics-following-diep-versus-muscle-sparing-free-tram-flap-breast-reconstruction
#8
Hirokazu Uda, Hideaki Kamochi, Syunji Sarukawa, Ataru Sunaga, Yasusih Sugawara, Kotaro Yoshimura
BACKGROUND: The deep inferior epigastric perforator (DIEP) flap, which is a modification of the muscle-sparing free transverse rectus abdominis musculocutaneous (msTRAM) flap, is being more frequently used in an effort to reduce postoperative abdominal morbidity. However, there is no consensus as to which of these flaps is superior. We aimed to compare quantitative measurements of abdominal function obtained with an isokinetic dynamometer after DIEP and msTRAM flap elevation. METHODS: Patients who underwent unilateral single-pedicled DIEP (n = 42) or msTRAM flap (n = 36) breast reconstruction performed by a single surgeon were included in this study...
August 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28740793/donor-site-complications-and-remnant-of-rectus-abdominis-muscle-status-after-transverse-rectus-abdominis-myocutaneous-flap-reconstruction
#9
Prakasit Chirappapha, Noppadol Trikunagonvong, Duangkamon Prapruttam, Sasiprapa Rongthong, Panuwat Lertsithichai, Thongchai Sukarayothin, Monchai Leesombatpaiboon, Rujira Panawattanakul, Panya Thaweepworadej
BACKGROUND: Transverse rectus abdominis myocutaneous (TRAM) flap reconstruction after mastectomy in breast cancer patients has become one of the milestones in breast reconstruction. There are several techniques that have been used in an attempt to minimize untoward complications. We present the whole muscle with partial sheath-sparing technique that focuses on the anatomy of arcuate line and the closure of the anterior abdominal wall techniques with mesh and determine factors associated with its complications and outcomes...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28713703/comparative-perfusion-analysis-of-free-muscle-sparing-versus-pedicle-transverse-rectus-abdominis-myocutaneous-tram-flaps-in-vivo-in-the-peri-operative-and-late-post-operative-periods
#10
Richard McNally, Jonathan Rimler, Vincent Laurence, Keyianoosh Z Paydar, Garrett A Wirth
BACKGROUND: Current teaching suggests increased perfusion in free transverse rectus abdominis myocutaneous (TRAM) flaps over pedicled TRAM flaps, broadening indications for its use in high risk patients. This study compared perfusion analysis of free muscle-sparing versus pedicle TRAM flaps in vivo in the peri-operative and late post-operative periods. METHODS: The SPY-Elite system using indocyanine green dye was used to analyze flap perfusion intra-operatively and at 1 week and 3 months post-operatively...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28688657/umbilical-necrosis-rates-after-abdominal-based-microsurgical-breast-reconstruction
#11
Joseph A Ricci, Parisa Kamali, Babette E Becherer, Daniel Curiel, Winona Wu, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Umbilical stalk necrosis represents a rare, yet important complication after abdominal-based microsurgical breast reconstruction, which is both underrecognized and understudied in the literature. Once identified, umbilical reconstruction can be an extremely challenging problem. METHODS: All consecutive breast free flaps at a single institution from February 2004 to February 2016 were reviewed, excluding non-abdominal-based flaps. Patients were divided based on the development of umbilical necrosis postoperatively...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28682914/multiple-pedicled-flaps-cover-for-large-defects-following-resection-of-malignant-tumors-with-partition-concept
#12
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)
https://www.readbyqxmd.com/read/28673764/how-to-assess-sensory-recovery-after-breast-reconstruction-surgery
#13
Helena K Puonti, Taina A Broth, Seppo O Soinila, Helena K Hallikainen, Satu K Jääskeläinen
BACKGROUND: We evaluated clinical against psychophysical (tactile and thermal quantitative sensory test [QST]), neurophysiologic (somatosensory evoked potential [SEP]), and epithelial nerve fiber density (ENFD) examinations in detection and follow-up of sensory alterations after breast reconstruction done with or without nerve anastomoses. PATIENTS AND METHODS: In a prospective 2-year follow-up design, 56 breast cancer patients underwent innervated and 20 patients noninnervated free rectus abdominis muscle-sparing flap (ms-TRAM) breast reconstruction...
October 2017: Clinical Breast Cancer
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
#14
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/28602267/post-reconstruction-dermatitis-of-the-breast
#15
A C Rosen, C Goh, M E Lacouture, B J Mehrara, P G Cordeiro, P L Myskowski
BACKGROUND: Approximately one-third of women diagnosed with breast cancer undergo mastectomy with subsequent implant-based or autogenous tissue-based reconstruction. Potential complications include infection, capsular contracture, and leak or rupture of implants with necessity for explantation. Skin rashes are infrequently described complications of patients who undergo mastectomy with or without reconstruction. METHODS: A retrospective analysis of breast cancer patients referred to the Dermatology Service for diagnosis and management of a rash post-mastectomy and expander or implant placement or transverse rectus abdominis myocutaneous (TRAM) flap reconstruction was performed...
October 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28590974/successful-breast-reconstruction-with-a-free-muscle-sparing-tram-flap-in-a-patient-with-prior-ligation-of-the-bilateral-deep-inferior-epigastric-vessels
#16
LETTER
Albert H Chao
No abstract text is available yet for this article.
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28560022/combined-tram-flap-with-latissimus-dorsi-myocutaneous-flap-for-reconstruction-of-a-large-breast-post-radiation-induced-necrosis
#17
Ahmed Al Maksoud, Mohammed Moneer, Adel K Barsoum
Radiation therapy is a critical component of breast cancer management following breast-conserving surgery. Post-radiation sequelae are greater in women with larger breasts, given the need for higher doses and dosing heterogeneity. The goal of breast reconstruction post-mastectomy is to improve the quality of life and add no more health risk. The optimal reconstruction should make the patient feel as natural as possible. Reconstruction of a large-sized breast with aesthetically satisfactory outcome poses a challenge to the breast surgeon...
May 2017: Journal of Surgical Case Reports
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
#18
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/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#19
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
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
#20
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
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