USE OF SYNTHETIC MESH FOR THE ENTIRE ABDOMINAL-WALL AFTER TRAM FLAP TRANSFER

Abdominal wall competence is a major concern of all plastic surgeons u sing the TRAM flap for breast reconstruction. Low hernia rates and ade quate abdominal stability are standard expectations in abdominal wall closure. Described here is this institution's experience with the use of a large piece of synthetic mesh as a supplementary reinforcement fo r the entire abdominal wall in an attempt to stabilize it and achieve a superior abdominal aesthetic result. Twenty-five consecutive patient s had routine reinforcement,vith the extended mesh technique. Mean pat ient follow-up was 24 months with a minimum of 1 year. No hernia or me sh-related infection were encountered and only one patient had a lower abdominal bulge. We recommend the use of a large synthetic mesh for i mproved strength and aesthetic quality of the abdominal wall after TRA M flap breast reconstruction.