Three-layer primary closure of the bipedicled TRAM flap donor site for unilateral breast reconstruction: A 15-year experience with 124 consecutive patients

Karagöz H., Şahin C., Sever C., Külahçi Y., Eren F., Cesur C., ...Daha Fazla

Turkish Journal of Medical Sciences, cilt.47, sa.3, ss.861-867, 2017 (SCI-Expanded, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 47 Sayı: 3
  • Basım Tarihi: 2017
  • Doi Numarası: 10.3906/sag-1603-47
  • Dergi Adı: Turkish Journal of Medical Sciences
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.861-867
  • Anahtar Kelimeler: Abdominal hernia, donor site complication, pedicled transverse rectus abdominis myocutaneous flap, primary closure, TRAM flap
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

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.