title: Problems with the transverse rectus abdominis myocutaneous island flap in breast reconstruction.
abstract: The transverse rectus abdominis myocutaneous (TRAM) island flap would appear to be ideal for breast reconstruction where a significant skin and muscle deficiency exists after mastectomy. The flap is bulky enough to allow reconstruction without a prosthesis and leaves an excellent donor scar. However, in contrast to the impression gained from most reports, we have found the TRAM flap to have a high failure rate. Careful patient selection is essential to avoid flap necrosis.
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of the Witwatersrand, Johannesburg.
authors.forename: D R
authors.initials: DR
authors.lastname: Mackay
authors.forename: S A
authors.initials: SA
authors.lastname: Braun
authors.forename: R S
authors.initials: RS
authors.lastname: Stott
mesh_terms: D000009:Abdominal Muscles / Q000601:surgery*; D000328:Adult; D001940:Breast / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000534:rehabilitation; D008722:Methods; D008875:Middle Aged; D013524:Surgical Flaps