Selective salvage of zones 2 and 4 in the pedicled TRAM flap: a focus on reducing fat necrosis and improving aesthetic outcomes
| Autor: | Chi Sun Yoon, Kyu Nam Kim |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
Multidisciplinary business.industry Vascular anatomy medicine.medical_treatment Research Pedicled Flap TRAM 030230 surgery Microsurgery medicine.disease Surgery Tram flap 03 medical and health sciences Rectus abdominis 0302 clinical medicine Breast cancer Pedicled flap 030220 oncology & carcinogenesis Liposuction medicine Fat necrosis Breast reconstruction business |
| Zdroj: | SpringerPlus |
| ISSN: | 2193-1801 |
| DOI: | 10.1186/s40064-016-1714-7 |
| Popis: | The introduction of microsurgery has decreased the frequency of using the pedicled transverse rectus abdominis musculocutaneous (TRAM) flap, owing to its higher incidence of fat necrosis and limitations in flap insetting (vs. the free TRAM flap). We devised an efficient method of using zones 2 and 4, based on the pedicled flap’s vascular anatomy, to reduce fat necrosis and achieve superior aesthetic outcomes during immediate breast reconstruction using the pedicled TRAM flap. Between April 2011 and February 2015, we performed immediate breast reconstruction using the contralateral unipedicled TRAM flap for 136 breast cancer patients. The conventional method (insetting by removing zone 4 and part of zone 2) was used for 83 patients (Group A), and selective salvage of zones 2 and 4 (our proposed method) was used for 53 patients (Group B). Fat necrosis was observed in 17 patients (20.48 %) and 4 patients (7.55 %) from Groups A and B, respectively (p = 0.033). The average patient satisfaction scores at 6 months (comparing the reconstructed and contralateral breasts) were 7.01 and 8.02 in Groups A and B, respectively (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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