- Turkish Journal of Medical Sciences
- Vol: 47 Issue: 3
- Three-layer primary closure of the bipedicled TRAM flap donor site for unilateral breast reconstruct...
Three-layer primary closure of the bipedicled TRAM flap donor site for unilateral breast reconstruction: a 15-year experience with 124 consecutive patients
Authors : Hüseyin Karagöz, Cihan Şahin, Celalettin Sever, Yalçin Külahci, Fikret Eren, Ceyhun Cesur, Fuat Yüksel
Pages : 861-867
View : 14 | Download : 2
Publication Date : 9999-12-31
Article Type : Makaleler
Abstract :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.Keywords : Abdominal hernia, donor site complication, pedicled transverse rectus abdominis myocutaneous flap, primary closure, TRAM flap