Sensory Restoration of Abdomen after Free TRAM Flap for Breast Reconstruction

ABSTRACT

The purpose of this study is to assess abdominal sensation after free TRAM flap for breast reconstruction. 74 patients underwent breast reconstruction with free TRAM flap by authors and were followed up to check the sensation on abdomen following the surgery at the out patient clinic. They are compared with 20 female volunteer controls. Abdomens were divided into 13 zones, and assessed for superficial touch, superficial pain, temperature, two-point discrimination, and vibration. For all five sensory modalities, subjects were found to have decreased sensation in the umbilical and infraumbilical regions. This was statistically significant compared with controls. Division following pedicle dissection showed more reduction of sensation than non-dissection side. Both Inguinal areas below the donor site closure also showed markedly decreased sensation. Sensation on most area of abdomen recovered in postoperative 1 year, however, there were remained hypoesthesia in umbilical and infraumbilical area after post operative 1 year. This study clearly demonstrates that there is a significant and persistent reduction in abdominal sensibility following free TRAM flap surgery.