Superdrained transverse rectus abdominis myocutaneous flap: a gold standard for immediate breast reconstrucion??

ABSTRACT

Pedicled transverse rescuts abdominis myocutaneous [tram] flap have been used with an increasing frequency in immediate breast reconstruction following mastectomy. The high incidence of venous compromise and partial flap necrosis rendered the outcome unsatisfactory in several patients. Cadaver studies that demonstrated presence of valves in the inferior epigastria vein that impede retrograde flow, led to the logic modification of performing a superdrainage augmentation of that vein into the thoracodrorsal vein. In the present study 20 conventional contralaeral tram flaps were used as a primary procedure for breast reconstruction with superdarinage augmentation. The 90% success rate suggests that this procedure that consumes very little abdominal operative renders the surgery much safer and markedly improves flap survival. It is strongly recommend to be in all tram rerconstructions