SUPERIORITY OF THE MICROVASCULARLY AUGMENTED FLAP - ANALYSIS OF 50 TRANSVERSE RECTUS-ABDOMINIS MYOCUTANEOUS FLAPS FOR BREAST RECONSTRUCTION

Our experience with 50 transverse rectus abdominis myocutaneous (TRAM) flap transfers was evaluated as to the types of TRAM flaps, indicatio ns for breast reconstruction with a TRAM flap, and complications. The TRAM flap was transferred as a fr ee flap in 7 patients, a unipedicled flap in 14 patients, and a microvascularly augmented flap in 29 patie nts. Microvascular augmentation was performed through the contralatera l inferior epigastric vascular system to the superiorly pedicled muscl e in 10 patients who had undergone radical mastectomy and the ipsilate ral inferior epigastric vascular system in 19 patients who had undergo ne modified radical mastectomy. In this series, the incidence of flap- site complications, including total flap loss, partial flap loss, and fat necrosis, was lowest in the microvascularly augmented flap group. Particularly, incidence of partial flap loss in the microvascularly au gmented flap group was significantly lower than in the unipedicled fla p group (p < O.O1). These outcomes demonstrated the superiority of the microvascularly augmented TRAM flap for breast reconstruction.