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. Materials and methods: A retrospective study was performed that included patients who underwent bipedicled TRAM flap breast reconstruction with the three-layer primary closure technique. Between 2000 and 2015, 124 breast reconstruction patients were reviewed for donor site morbidity. Results: During the 15-year study period, 106 patients had conventional bipedicled TRAM flaps and 18 had bipedicled TRAM flaps with a surgical delay procedure. For all groups, none of the patients developed abdominal wall hernia, but three patients had bulging. Partial flap loss was the most common flap complication, present in 6 flaps (4.8%). Conclusion: The suturing technique studied provided abdominal wall closure without the use of a mesh even when utilizing a bilateral pedicle with very low complication rates.
Abdominal hernia, donor site complication, pedicled transverse rectus abdominis myocutaneous flap, primary closure, TRAM flap
KARAGÖZ, HÜSEYİN; ŞAHİN, CİHAN; SEVER, CELALETTİN; KÜLAHCI, YALÇIN; EREN, FİKRET; CESUR, CEYHUN; and YÜKSEL, FUAT
"Three-layer primary closure of the bipedicled TRAM flap donor site for unilateralbreast reconstruction: a 15-year experience with 124 consecutive patients,"
Turkish Journal of Medical Sciences: Vol. 47:
3, Article 22.
Available at: https://journals.tubitak.gov.tr/medical/vol47/iss3/22