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Case Report : Latissimus Dorsi Flap for Secondary Breast Reconstruction after Partial TRAM Flap Loss  

Song, Jae Min (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook national university)
Yang, Jung Duk (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook national university)
Lee, Sang Yun (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook national university)
Jung, Ki Ho (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook national university)
Jung, Ho Yun (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook national university)
Cho, Byung Chae (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook national university)
Publication Information
Archives of Plastic Surgery / v.36, no.1, 2009 , pp. 75-79 More about this Journal
Abstract
Purpose: The transverse rectus abdominis musculocutaneous(TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. Postoperatively, partial flap loss or fat necrosis are relatively common and it may result in a smaller breast volume with marked contour irregularities. These defects are not easy to reconstruct with local tissue rearrangement or with breast implants. The current authors present the results of 2 patients who underwent Latissimus dorsi(LD) flap reconstruction to correct partial flap or fat necrosis that developed after TRAM flap breast reconstruction. Method: Case1: A 50 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively partial flap necrosis was developed. Secondary breast reconstruction using LD flap was done. Case2: A 51 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively fat necrosis was developed. Secondary breast reconstruction using LD flap was done. Results: Secondary breast reconstruction using LD flap survived completely and produce successful reconstruction. There was no significant complication in both patients. Conclusion: LD flap provides sufficient, vascularized skin and soft tissue. The flap can be molded easily to replace deficient tissue in all areas of the breast. These attributes make it an ideal candidate for salvage of the partially failed TRAM flap breast reconstructio.
Keywords
TRAM flap; Partial flap necrosis; Fat necrosis; LD flap;
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