Inclusion of Mesh in Donor-Site Repair of Free TRAM and Muscle-Sparing Free TRAM Flaps Yields Rates of Abdominal Complications Comparable to Those of DIEP Flap Reconstruction

Abstract

Incorporating mesh into rectus fascia repair in free and muscle-sparing free TRAM flap cases significantly reduces the rate of postoperative abdominal complications to levels equivalent to those for DIEP flap reconstructions. The authors advocate deciding intraoperatively between DIEP and muscle-sparing free TRAM flap dissections based on ease of dissection and whichever offers optimal safety and flap perfusion. Routine use of mesh in donor-site repair will decrease postoperative abdominal morbidity in unilateral and bilateral cases.

The DIEP flap breast reconstruction: Starting from scratch in a university hospital

“…This perforator flap provides a natural and definitive reconstruction with low abdominal wall sequelae [9,10]. However, successful outcomes require high-level surgical skills gained from accumulated years of experience.…”

Effects of Obesity on Postoperative Complications After Breast Reconstruction Using Free Muscle-Sparing Transverse Rectus Abdominis Myocutaneous, Deep Inferior Epigastric Perforator, and Superficial Inferior Epigastric Artery Flap

“…Among these, 15 presented data for msTRAM, DIEP, or SIEA flaps, and 8 of these 15 described complication rates for both obese and nonobese patients and thus were considered for estimating the RR 20,21,23,[25][26][27][28][29] (Table 1). Four studies presented data only for DIEP flaps 20,21,28,29 ; 3, for msTRAM and DIEP flaps [25][26][27] ; and 1, for msTRAM, DIEP, and SIEA flaps. 23 These studies were also included for the summarization of pooled complication rates except for 1 with fewer than 10 patients in each subgroup.…”

Reinforcement of the Abdominal Wall following Breast Reconstruction with Abdominal Flaps

“…7,[15][16][17][18] In one study, Wan et al examined the use of polypropylene mesh in free TRAM, muscle-sparing TRAM, and DIEP flap reconstruction. 19 The authors noted a reduction in hernia/bulge from 12.0 percent to 3.7 percent in free TRAM and muscle-sparing TRAM flaps with the use of inlay polypropylene mesh when primary facial closure was not possible compared with primary facial closure.…”