The free transverse rectus abdominis musculocutaneous flap for breast reconstruction: one center's experience with 211 consecutive cases
All patients undergoing breast reconstruction with free transverse rectus abdominis musculocutaneous (TRAM) flaps from February 1989 to November 1992 were registered into a computerized database and followed prospectively. There were 211 free TRAM flap breast reconstructions in 163 patients; 48 reco...
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| Veröffentlicht in: | Annals of plastic surgery 1994-03, Vol.32 (3), p.234-41; discussion 241-2 |
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| container_end_page | 41; discussion 241-2 |
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| container_title | Annals of plastic surgery |
| container_volume | 32 |
| creator | Schusterman, M A Kroll, S S Miller, M J Reece, G P Baldwin, B J Robb, G L Altmyer, C S Ames, F C Singletary, S E Ross, M I |
| description | All patients undergoing breast reconstruction with free transverse rectus abdominis musculocutaneous (TRAM) flaps from February 1989 to November 1992 were registered into a computerized database and followed prospectively. There were 211 free TRAM flap breast reconstructions in 163 patients; 48 reconstructions were bilateral. A muscle split technique was used in 108 of 211 reconstructions (51%). Total flap loss occurred in 3 of 211 reconstructions for a success rate of 99%. Complications occurred in 81 of 211 reconstructions (38%). Fat necrosis or partial flap loss occurred in 15 of 211 (7%). Hernia or bulge occurred in 11 patients (5%). The bulge/hernia rate tended to be lower in the muscle split group (4 of 108 [4%]) than in those who did not have muscle split procedures (7 of 103 [7%]), whereas the fat necrosis rate was slightly higher in the former group (9 of 108 [8%]) than in the latter (6 of 103 [6%]). Neither difference was statistically significant. However, patients who currently or previously smoked cigarettes did have a significantly higher incidence of fat necrosis: 12 of 99 smokers (12%) had fat necrosis compared with 3 of 112 nonsmokers (3%; p = 0.02). |
| doi_str_mv | 10.1097/00000637-199403000-00002 |
| format | Article |
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There were 211 free TRAM flap breast reconstructions in 163 patients; 48 reconstructions were bilateral. A muscle split technique was used in 108 of 211 reconstructions (51%). Total flap loss occurred in 3 of 211 reconstructions for a success rate of 99%. Complications occurred in 81 of 211 reconstructions (38%). Fat necrosis or partial flap loss occurred in 15 of 211 (7%). Hernia or bulge occurred in 11 patients (5%). The bulge/hernia rate tended to be lower in the muscle split group (4 of 108 [4%]) than in those who did not have muscle split procedures (7 of 103 [7%]), whereas the fat necrosis rate was slightly higher in the former group (9 of 108 [8%]) than in the latter (6 of 103 [6%]). Neither difference was statistically significant. However, patients who currently or previously smoked cigarettes did have a significantly higher incidence of fat necrosis: 12 of 99 smokers (12%) had fat necrosis compared with 3 of 112 nonsmokers (3%; p = 0.02).</description><identifier>ISSN: 0148-7043</identifier><identifier>DOI: 10.1097/00000637-199403000-00002</identifier><identifier>PMID: 8192381</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Fat Necrosis ; Female ; Hernia, Ventral ; Humans ; Mammaplasty - methods ; Middle Aged ; Postoperative Complications ; Prospective Studies ; Rectus Abdominis - transplantation ; Skin Transplantation - methods ; Surgical Flaps</subject><ispartof>Annals of plastic surgery, 1994-03, Vol.32 (3), p.234-41; discussion 241-2</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8192381$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schusterman, M A</creatorcontrib><creatorcontrib>Kroll, S S</creatorcontrib><creatorcontrib>Miller, M J</creatorcontrib><creatorcontrib>Reece, G P</creatorcontrib><creatorcontrib>Baldwin, B J</creatorcontrib><creatorcontrib>Robb, G L</creatorcontrib><creatorcontrib>Altmyer, C S</creatorcontrib><creatorcontrib>Ames, F C</creatorcontrib><creatorcontrib>Singletary, S E</creatorcontrib><creatorcontrib>Ross, M I</creatorcontrib><title>The free transverse rectus abdominis musculocutaneous flap for breast reconstruction: one center's experience with 211 consecutive cases</title><title>Annals of plastic surgery</title><addtitle>Ann Plast Surg</addtitle><description>All patients undergoing breast reconstruction with free transverse rectus abdominis musculocutaneous (TRAM) flaps from February 1989 to November 1992 were registered into a computerized database and followed prospectively. There were 211 free TRAM flap breast reconstructions in 163 patients; 48 reconstructions were bilateral. A muscle split technique was used in 108 of 211 reconstructions (51%). Total flap loss occurred in 3 of 211 reconstructions for a success rate of 99%. Complications occurred in 81 of 211 reconstructions (38%). Fat necrosis or partial flap loss occurred in 15 of 211 (7%). Hernia or bulge occurred in 11 patients (5%). The bulge/hernia rate tended to be lower in the muscle split group (4 of 108 [4%]) than in those who did not have muscle split procedures (7 of 103 [7%]), whereas the fat necrosis rate was slightly higher in the former group (9 of 108 [8%]) than in the latter (6 of 103 [6%]). Neither difference was statistically significant. However, patients who currently or previously smoked cigarettes did have a significantly higher incidence of fat necrosis: 12 of 99 smokers (12%) had fat necrosis compared with 3 of 112 nonsmokers (3%; p = 0.02).</description><subject>Adult</subject><subject>Fat Necrosis</subject><subject>Female</subject><subject>Hernia, Ventral</subject><subject>Humans</subject><subject>Mammaplasty - methods</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Rectus Abdominis - transplantation</subject><subject>Skin Transplantation - methods</subject><subject>Surgical Flaps</subject><issn>0148-7043</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9UMtOwzAQ9AFUyuMTkHyCU8CvOjE3VPGSKnEp58hxNmpQEgevU-AP-GwSWrqX1e7OzO4OIZSzG85Mesum0DJNuDGKybFIpo44InPGVZakTMkTcor4zhgXmdIzMsu4ETLjc_Kz3gCtAgCNwXa4hYBAA7g4ILVF6du6q5G2A7qh8W6ItgM_jqrG9rTygRYBLMaJ4TuMYXCx9t0d9R1QB12EcI0UvnoINXQO6GcdN1RwTic4jHr1dgRaBDwnx5VtEC72-Yy8PT6sl8_J6vXpZXm_Stx4ekyUBV5aXgjNocyYNkKpSmYFlJIpt7CuUIyzonBCaViATCtrUsXFQgtrtdHyjFztdPvgPwbAmLc1Omia3Wd5qpVJMy1GYLYDuuARA1R5H-rWhu-cs3wyPv83Pj8Y_9eaqJf7HUPRQnkg7l2Xv3E3gzg</recordid><startdate>19940301</startdate><enddate>19940301</enddate><creator>Schusterman, M A</creator><creator>Kroll, S S</creator><creator>Miller, M J</creator><creator>Reece, G P</creator><creator>Baldwin, B J</creator><creator>Robb, G L</creator><creator>Altmyer, C S</creator><creator>Ames, F C</creator><creator>Singletary, S E</creator><creator>Ross, M I</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19940301</creationdate><title>The free transverse rectus abdominis musculocutaneous flap for breast reconstruction: one center's experience with 211 consecutive cases</title><author>Schusterman, M A ; Kroll, S S ; Miller, M J ; Reece, G P ; Baldwin, B J ; Robb, G L ; Altmyer, C S ; Ames, F C ; Singletary, S E ; Ross, M I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c284t-4ae1da1b261ed8069244f38bed304c5acb4010bbc246e5e37fa97412562aa6963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Fat Necrosis</topic><topic>Female</topic><topic>Hernia, Ventral</topic><topic>Humans</topic><topic>Mammaplasty - methods</topic><topic>Middle Aged</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Rectus Abdominis - transplantation</topic><topic>Skin Transplantation - methods</topic><topic>Surgical Flaps</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schusterman, M A</creatorcontrib><creatorcontrib>Kroll, S S</creatorcontrib><creatorcontrib>Miller, M J</creatorcontrib><creatorcontrib>Reece, G P</creatorcontrib><creatorcontrib>Baldwin, B J</creatorcontrib><creatorcontrib>Robb, G L</creatorcontrib><creatorcontrib>Altmyer, C S</creatorcontrib><creatorcontrib>Ames, F C</creatorcontrib><creatorcontrib>Singletary, S E</creatorcontrib><creatorcontrib>Ross, M I</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schusterman, M A</au><au>Kroll, S S</au><au>Miller, M J</au><au>Reece, G P</au><au>Baldwin, B J</au><au>Robb, G L</au><au>Altmyer, C S</au><au>Ames, F C</au><au>Singletary, S E</au><au>Ross, M I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The free transverse rectus abdominis musculocutaneous flap for breast reconstruction: one center's experience with 211 consecutive cases</atitle><jtitle>Annals of plastic surgery</jtitle><addtitle>Ann Plast Surg</addtitle><date>1994-03-01</date><risdate>1994</risdate><volume>32</volume><issue>3</issue><spage>234</spage><epage>41; discussion 241-2</epage><pages>234-41; discussion 241-2</pages><issn>0148-7043</issn><abstract>All patients undergoing breast reconstruction with free transverse rectus abdominis musculocutaneous (TRAM) flaps from February 1989 to November 1992 were registered into a computerized database and followed prospectively. There were 211 free TRAM flap breast reconstructions in 163 patients; 48 reconstructions were bilateral. A muscle split technique was used in 108 of 211 reconstructions (51%). Total flap loss occurred in 3 of 211 reconstructions for a success rate of 99%. Complications occurred in 81 of 211 reconstructions (38%). Fat necrosis or partial flap loss occurred in 15 of 211 (7%). Hernia or bulge occurred in 11 patients (5%). The bulge/hernia rate tended to be lower in the muscle split group (4 of 108 [4%]) than in those who did not have muscle split procedures (7 of 103 [7%]), whereas the fat necrosis rate was slightly higher in the former group (9 of 108 [8%]) than in the latter (6 of 103 [6%]). Neither difference was statistically significant. However, patients who currently or previously smoked cigarettes did have a significantly higher incidence of fat necrosis: 12 of 99 smokers (12%) had fat necrosis compared with 3 of 112 nonsmokers (3%; p = 0.02).</abstract><cop>United States</cop><pmid>8192381</pmid><doi>10.1097/00000637-199403000-00002</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0148-7043 |
| ispartof | Annals of plastic surgery, 1994-03, Vol.32 (3), p.234-41; discussion 241-2 |
| issn | 0148-7043 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_76497862 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Fat Necrosis Female Hernia, Ventral Humans Mammaplasty - methods Middle Aged Postoperative Complications Prospective Studies Rectus Abdominis - transplantation Skin Transplantation - methods Surgical Flaps |
| title | The free transverse rectus abdominis musculocutaneous flap for breast reconstruction: one center's experience with 211 consecutive cases |
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