Minimizing Donor-Site Morbidity Following Bilateral Pedicled TRAM Breast Reconstruction With the Double Mesh Fold Over Technique

Bharti, Gaurav; Groves, Leslie; Sanger, Claire; Thompson, James T.; David, Lisa R.; Marks, Malcolm W.

doi:10.1097/sap.0b013e31828569c0

Cited by 11 publications

(7 citation statements)

References 19 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Certain strategies used to increase the intrinsic vascularity of TRAM flap are double pedicled, supercharged or free transfer of the flap . Whereas these strategies have disadvantages such as increasing donor site morbidity, operative time, hospitalization period and postoperative complications . On the clinical setting, one of the most reliable procedure to increase zone 4 survival is using “delay phenomenon” .…”

Section: Discussionmentioning

confidence: 99%

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Çalış¹,

Demirtas

Sert³

et al. 2019

Lasers Surg Med

View full text Add to dashboard Cite

Objective The aim of this study was to evaluate the effect of relatively novel approach of application of polychromatic light waves on flap survival of experimental musculocutaneous flap model and to investigate efficacy of this modality as a delay procedure to increase vascularization of zone 4 of transverse rectus abdominis musculocutaneous (TRAM) flap. Methods Twenty‐one Wistar rats were randomized and divided into 3 experimental groups (n = 7 each). In group 1 (control group), after being raised, the TRAM flap was sutured back to its bed without any further intervention. In group 2 (delay group), photobiomodulation (PBM) was applied for 7 days as a delay procedure, before elevation of the flap. In group 3 (PBM group), the TRAM flap was elevated, and PBM was administered immediately after the flap was sutured back to its bed for therapeutic purpose. PBM was applied in 48 hours interval from 10 cm. distance to the whole abdominal wall both in groups 2 and 3 for one week. After 7 days of postoperative follow‐up, as the demarcation of necrosis of the skin paddle was obvious, skin flap survival was further evaluated by macroscopic, histological and microangiographic analysis. Results The mean percentage of skin flap necrosis was 56.17 ± 23.68 for group 1, 30.92 ± 17.46 for group 2 and 22.73 ± 12.98 for group 3 PBM receiving groups 2 and 3 revealed less necrosis when compared to control group and this difference was statistically significant. Vascularization in zone 4 of PBM applied groups 2 and 3 was higher compared to group 1 (P = 0.001). Acute inflammation in zone 4 of group 1 was significantly higher compared to groups 2 and 3 (P = 0.025). Similarly, evaluation of zone 1 of the flaps reveled more inflammation and less vascularization among the samples of the control group (P = 0.006 and P = 0.007, respectively). Comparison of PBM receiving two groups did not demonstrate further difference in means of vascularization and inflammation density (P = 0.259). Conclusion Application of PBM in polychromatic fashion enhances skin flap survival in experimental TRAM flap model both on preoperative basis as a delay procedure or as a therapeutic approach. Lasers Surg. 51:538–549, 2019. © 2019 Wiley Periodicals, Inc.

show abstract

Section: Discussionmentioning

confidence: 99%

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Çalış¹,

Demirtas

Sert³

et al. 2019

Lasers Surg Med

View full text Add to dashboard Cite

show abstract

“…double polypropylene mesh fold over, acellular dermal matrix insertion and the use of quilting sutures. 12,13,16,17 As…”

Section: Discussionmentioning

confidence: 99%

The drain game: Abdominal drains for transverse rectus abdominis myocutaneous breast reconstruction

Miranda¹,

Wilson²,

Amin³

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

View full text Add to dashboard Cite

“… 1 Another option is to add a mesh to the abdominal wall closure, which is also associated with low rates of abdominal bulging and hernia. 2 – 4 In this scenario, meshes are placed as an onlay or as an inlay. 1 In patients undergoing ventral hernia repair, inlay meshes are associated with high recurrence rates because of disruption of mesh-to-muscle interface.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Another option involves the addition of mesh during abdominal wall closure, for which rates of abdominal bulging and ventral hernias are 2% to 6% and 1% to 2%, respectively. 2 – 4 Cost utility of mesh reinforcement has been well established. 5 Traditionally, meshes are placed as a subcutaneous onlay or as an inlay.…”

mentioning

confidence: 99%

Abdominal Closure after TRAM Flap Breast Reconstruction with Transversus Abdominis Muscle Release and Mesh

Espinosa-de-los-Monteros¹,

Avendaño-Peza

Novitsky³

2016

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary:Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction.

show abstract

Minimizing Donor-Site Morbidity Following Bilateral Pedicled TRAM Breast Reconstruction With the Double Mesh Fold Over Technique

Abstract: The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia.

Cited by 11 publications

References 19 publications

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

The drain game: Abdominal drains for transverse rectus abdominis myocutaneous breast reconstruction

Abdominal Closure after TRAM Flap Breast Reconstruction with Transversus Abdominis Muscle Release and Mesh

Contact Info

Product

Resources

About