Archives of Plastic Surgery

  • 제39권1호
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  • Pages.3-10
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  • 2012
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Breast Reconstruction with Microvascular MS-TRAM and DIEP Flaps

  • Chang, David W. (Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center)
  • 투고 : 2009.10.30
  • 심사 : 2011.11.19
  • 발행 : 2012.01.15
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초록

The free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) and deep inferior epigastric perforator (DIEP) flaps involve transferring skin and subcutaneous tissue from the lower abdominal area and have many features that make them well suited for breast reconstruction. The robust blood supply of the free flap reduces the risk of fat necrosis and also enables aggressive shaping of the flap for breast reconstruction to optimize the aesthetic outcome. In addition, the free MS-TRAM flap and DIEP flap require minimal donor-site sacrifice in most cases. With proper patient selection and safe surgical technique, the free MS-TRAM flap and DIEP flap can transfer the lower abdominal skin and subcutaneous tissue to provide an aesthetically pleasing breast reconstruction with minimal donor-site morbidity.

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참고문헌

  1. Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction: an experimental study and clinical case report. Scand J Plast Reconstr Surg 1979;13:423-27. https://doi.org/10.3109/02844317909013092
  2. Roehl KR, Baumann DP, Chevray PM, et al. Evaluation of outcomes in breast reconstructions combining lower abdominal free flaps and permanent implants. Plast Reconstr Surg 2010;126:349-57. https://doi.org/10.1097/PRS.0b013e3181de1b67
  3. Chang DW, Reece GP, Wang B, et al. Effect of smoking on complications in patients undergoing free TRAM flap breast reconstruction. Plast Reconstr Surg 2000;105:2374-80. https://doi.org/10.1097/00006534-200006000-00010
  4. Chang DW, Wang B, Robb GL, et al. Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction. Plast Reconstr Surg 2000;105:1640-8. https://doi.org/10.1097/00006534-200004050-00007
  5. Kim JY, Chang DW, Temple C, et al. Free transverse rectus abdominis musculocutaneous flap breast reconstruction in patients with prior abdominal suction-assisted lipectomy. Plast Reconstr Surg 2004;113:28e-31e. https://doi.org/10.1097/01.PRS.0000105631.84512.3B
  6. Lipa JE, Youssef AA, Kuerer HM, et al. Breast reconstruction in older women: advantages of autogenous tissue. Plast Reconstr Surg 2003;111:1110-21. https://doi.org/10.1097/01.PRS.0000046614.84464.84
  7. Miller RB, Reece G, Kroll SS, et al. Microvascular breast reconstruction in the diabetic patient. Plast Reconstr Surg 2007;119:38-45. https://doi.org/10.1097/01.prs.0000244745.21562.58
  8. Heller L, Feledy JA, Chang DW. Strategies and options for free TRAM flap breast reconstruction in patients with midline abdominal scars. Plast Reconstr Surg 2005;116:753-9. https://doi.org/10.1097/01.prs.0000176252.29645.d0
  9. Tran NV, Chang DW, Gupta A, et al. Comparison of immediate and delayed free TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg 2001;108:78-82. https://doi.org/10.1097/00006534-200107000-00013
  10. Chang DW, Barnea Y, Robb GL. Effects of an autologous flap combined with an implant for breast reconstruction: an evaluation of 1000 consecutive reconstructions of previously irradiated breasts. Plast Reconstr Surg 2008;122:356-62. https://doi.org/10.1097/PRS.0b013e31817d6303
  11. Chang DW, Kim S. Breast reconstruction and lymphedema. Plast Reconstr Surg 2010;125:19-23.
  12. Saint-Cyr M, Youssef A, Bae HW, et al. Changing trends in recipient vessel selection for microvascular autologous breast reconstruction: an analysis of 1483 consecutive cases. Plast Reconstr Surg 2007;119:1993-2000. https://doi.org/10.1097/01.prs.0000260636.43385.90
  13. Saint-Cyr M, Chang DW, Robb GL, et al. Internal mammary perforator recipient vessels for breast reconstruction using free TRAM, DIEP, and SIEA flaps. Plast Reconstr Surg 2007;120:1769-73. https://doi.org/10.1097/01.prs.0000287132.35433.d6
  14. Sacks JM, Chang DW. Rib-sparing internal mammary vessel harvest for microvascular breast reconstruction in 100 consecutive cases. Plast Reconstr Surg 2009;123:1403-7. https://doi.org/10.1097/PRS.0b013e3181a07249
  15. Bajaj AK, Chevray PM, Chang DW. Comparison of donorsite complications and functional outcomes in free musclesparing TRAM flap and free DIEP flap breast reconstruction. Plast Reconstr Surg 2006;117:737-46. https://doi.org/10.1097/01.prs.0000200062.97265.fb
  16. Wu LC, Bajaj A, Chang DW, et al. Comparison of donorsite morbidity of SIEA, DIEP, and muscle-sparing TRAM flaps for breast reconstruction. Plast Reconstr Surg 2008;122:702-9. https://doi.org/10.1097/PRS.0b013e3181823c15

피인용 문헌

  1. Rib-Sparing and Internal Mammary Artery–Preserving Microsurgical Breast Reconstruction with the Free DIEP Flap vol.131, pp.3, 2012, https://doi.org/10.1097/prs.0b013e31827c6d38
  2. Comparison of Irradiated Versus Nonirradiated DIEP Flaps in Patients Undergoing Immediate Bilateral DIEP Reconstruction with Unilateral Postmastectomy Radiation Therapy (PMRT) vol.71, pp.3, 2012, https://doi.org/10.1097/sap.0b013e31828986ec
  3. Meta-analysis of the Safety and Factors Contributing to Complications of MS-TRAM, DIEP, and SIEA Flaps for Breast Reconstruction vol.38, pp.4, 2012, https://doi.org/10.1007/s00266-014-0333-3
  4. Is Holm Zone III safe from fat necrosis in medial row perforator‐based deep inferior epigastric perforator flaps? vol.35, pp.4, 2012, https://doi.org/10.1002/micr.22328
  5. Systematic review of effects of pregnancy on breast and abdominal contour after TRAM/DIEP breast reconstruction in breast cancer survivors vol.152, pp.1, 2012, https://doi.org/10.1007/s10549-015-3449-5
  6. Total ‘rib’-preservation technique of internal mammary vessel exposure for free flap breast reconstruction: A 5-year prospective cohort study and instructional video vol.4, pp.3, 2012, https://doi.org/10.1016/j.amsu.2015.08.006
  7. Patients’ Aesthetic Concerns After Horizontally Placed Abdominal Free Flap Breast Reconstruction vol.39, pp.5, 2012, https://doi.org/10.1007/s00266-015-0532-6
  8. Volumetric Planning Using Computed Tomographic Angiography Improves Clinical Outcomes in DIEP Flap Breast Reconstruction vol.137, pp.5, 2012, https://doi.org/10.1097/prs.0000000000002045
  9. Discussion: Does the Use of Incisional Negative-Pressure Wound Therapy Prevent Mastectomy Flap Necrosis in Immediate Expander-Based Breast Reconstruction? vol.138, pp.3, 2012, https://doi.org/10.1097/prs.0000000000002508
  10. Primary Fat Grafting to the Pectoralis Muscle during Latissimus Dorsi Breast Reconstruction vol.4, pp.11, 2012, https://doi.org/10.1097/gox.0000000000001059
  11. Opportunistic Biopsy of Internal Mammary Lymph Nodes During Immediate Breast Reconstruction After Mastectomy for Breast Malignancies vol.24, pp.7, 2017, https://doi.org/10.1245/s10434-017-5837-z
  12. A retrospective study of lymphatic transverse rectus abdominis myocutaneous/deep inferior epigastric perforator flaps for breast cancer treatment-induced upper-limb lymphoedema vol.7, pp.None, 2017, https://doi.org/10.1038/s41598-017-00164-1
  13. Perfusion of the diep flaps: A systematic review with meta‐analysis vol.38, pp.1, 2018, https://doi.org/10.1002/micr.30024
  14. The Pedicled LICAP Flap Combined with a Free Abdominal Flap In Autologous Breast Reconstructions vol.6, pp.1, 2012, https://doi.org/10.1097/gox.0000000000001562
  15. Breast cancer recurrence after reconstruction: know thine enemy vol.9, pp.45, 2012, https://doi.org/10.18632/oncotarget.25602
  16. The Outpatient DIEP: Safety and Viability following a Modified Recovery Protocol vol.6, pp.9, 2012, https://doi.org/10.1097/gox.0000000000001898
  17. The Analgesic Effects of Liposomal Bupivacaine versus Bupivacaine Hydrochloride Administered as a Transversus Abdominis Plane Block after Abdominally Based Autologous Microvascular Breast Reconstructi vol.144, pp.1, 2012, https://doi.org/10.1097/prs.0000000000005698
  18. A cost‐effectiveness analysis of DIEP vs free MS‐TRAM flap for microsurgical breast reconstruction vol.119, pp.3, 2012, https://doi.org/10.1002/jso.25325
  19. Effects of Antihypertensive Drugs on Outcomes of Breast Reconstruction vol.26, pp.6, 2012, https://doi.org/10.1245/s10434-019-07293-z
  20. Comparison of Phasix, polypropylene, and primary closure of the abdominal donor site after bilateral free flap breast reconstruction: Long‐term evaluation of abdominal hernia and bulge formation vol.40, pp.4, 2012, https://doi.org/10.1002/micr.30541
  21. Combined lymphovenous anastomosis and deep inferior epigastric perforator flap with lymphatic tissue preservation for defect reconstruction and lymphedema‐lymphocele prevention after medial thig vol.40, pp.5, 2012, https://doi.org/10.1002/micr.30558
  22. Ethnic variability in post‐mastectomy breast reconstruction in Counties Manukau District Health Board in 2017: a retrospective review vol.90, pp.7, 2020, https://doi.org/10.1111/ans.15894
  23. Impact of Smoking Status in Free Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction: A Multicenter Study vol.36, pp.9, 2012, https://doi.org/10.1055/s-0040-1714426
  24. Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study vol.302, pp.6, 2020, https://doi.org/10.1007/s00404-020-05779-w
  25. Abdominal Plication for Better Cosmetic Outcomes During Deep Inferior Epigastric Perforator Flap Breast Reconstruction vol.86, pp.6, 2012, https://doi.org/10.1097/sap.0000000000002874
  26. Combined pedicled superficial circumflex iliac artery perforator (SCIP) flap with lymphatic tissue preservation and lymphovenous anastomosis (LVA) for defect reconstruction and lymphedema–lympho vol.123, pp.1, 2012, https://doi.org/10.1002/jso.26228
  27. Comparison of venous couplers versus hand‐sewn technique in 4577 cases of DIEP‐flap breast reconstructions – A multicenter study vol.42, pp.1, 2022, https://doi.org/10.1002/micr.30686
  28. Higher body mass index is a more important risk factor than sarcopenia for complications in reconstruction of the deep inferior epigastric perforator vol.45, pp.1, 2012, https://doi.org/10.1016/j.asjsur.2021.06.059