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Usefulness of Muscle Plication and Synthetic Mesh in Breast Reconstruction Using TRAM Pedicled Flap  

Park, Jung Min (Department of Plastic and Reconstructive Surgery(Breast Center), College of Medicine, Dong-A University)
Park, Su Seong (Department of Plastic and Reconstructive Surgery(Breast Center), College of Medicine, Dong-A University)
Lee, Keun Cheol (Department of Plastic and Reconstructive Surgery(Breast Center), College of Medicine, Dong-A University)
Kim, Seok Kwun (Department of Plastic and Reconstructive Surgery(Breast Center), College of Medicine, Dong-A University)
Cho, Se Hyun (Department of Surgery(Breast Center), College of Medicine, Dong-A University)
Publication Information
Archives of Plastic Surgery / v.33, no.5, 2006 , pp. 643-647 More about this Journal
Abstract
Purpose: The transverse rectus abdominis myocutaneous(TRAM) flap has become a mainstay of breast reconstruction. The chief disadvantage of the TRAM flap is its potential to create a weakness in the abdominal wall. Nowadays true hernia is less frequent, but bulging that appears at the muscle donor site, or at the contralateral side, or at the epigastric area is still remained as a problem. To prevent this complications, we have used synthetic mesh as well as abdominal muscle plication. Now we report the result of our methods. Methods: We started to use synthetic mesh and muscle plication as supplementary reinforcement for entire abdominal wall, after TRAM flap harvesting, in an attempt to stabilize it and achieve a superior aesthetic result since 2002. We observed complications of TRAM flap donor site, and compared our results (from January, 2002 to January, 2006) with other operator's result (before 2001) at the same hospital in aspect of incidence of abdominal complications. Results: 42 consecutive patients have been performed routine reinforcement with the extended mesh technique and muscle plication from January, 2002 to January, 2006. Mean patient follow up was 25.2 months. No hernia or mesh related infection were encountered and only one patient had a mild abdominal bulging. Nevertheless the our good results, there were no significant statistical differences were observed between two groups. Conclusion: We recommend the using of synthetic mesh and muscle plication for donor site reconstruction after TRAM flap breast reconstruction to improve strength as well as aesthetic quality of the abdominal wall.
Keywords
Muscle plication; Synthetic mesh; TRAM;
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