title: Autogenous tissue reconstruction in the mastectomy patient. A critical review of 300 patients.
abstract: The transverse abdominal island flap operation was the method of breast reconstruction after mastectomy and in chest wall reconstruction in 300 patients from September 1980 to July 1986. In 58% (221 of 383 breast reconstructions), the breast mound was formed in a single operation and required no further revision. Only 18 reconstructed breasts required modification after 1 year. Symmetry was achieved without altering the opposite breast in 113 (52% of the 217 unilateral reconstructions). Complications included one total flap loss (0.3%) and 18 partial flap losses (6%). There was one lower abdominal hernia (0.3%) and two small defects in the upper anterior rectus sheath (0.8%). Lower abdominal wall laxity occurred in two patients (0.8%), one requiring repair. As expected, there was some loss of abdominal wall strength after reconstruction but this did not affect sports or work performance in over 90% of patients. Ninety-eight per cent of respondents (272 or 278) judged the operation worth their time and effort. This major operative procedure is indicated only in healthy patients.
mesh_terms: D000009:Abdominal Muscles / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D001940:Breast / Q000601:surgery*; D003258:Consumer Behavior; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D013903:Thoracic Surgery