IMMEDIATE TRANSVERSE RECTUS-ABDOMINIS MUSCULOCUTANEOUS FLAP RECONSTRUCTION AFTER MASTECTOMY

BACKGROUND: This study examines the early and long-term outcomes of im mediate transverse rectus abdominis musculocutaneous (TRAM) reconstruc tion of the breast after mastectomy. STUDY DESIGN: The records of all patients undergoing mastectomy and immediate TRAM breast reconstructio n between December 1989 and October 1993 were reviewed retrospectively using hospital and breast care center databases. RESULTS Fifty-three patients underwent a total of 73 immediate TRAM breast reconstructions . Reconstruction was successfully completed in all patients, using 46 pedicle flaps and 27 free tissue transfers. There were no flap losses or cardiopulmonary complications. Overall, the complication rate was 2 6 percent (29 percent for pedicle TRAM and 22 percent for free TRAM fl aps). The median follow-up period among the 53 patients was 22.6 month s (range of three to 48 months). Ah patients employed preoperatively r esumed their occupations postoperatively. CONCLUSIONS: Our experience indicates that immediate TRAM breast reconstruction is a safe and viab le option for patients seeking reconstruction at the time of mastectom y.