title: Transverse rectus abdominis musculocutaneous flap breast reconstruction in sickle cell disease.
abstract: Patients with homozygous sickle cell disease pose an enormous challenge to the reconstructive surgeon. Historically, the risk of attempting flap reconstruction was considered prohibitive. A successful case of immediate breast reconstruction with a "supercharged" bipedicled transverse rectus abdominis musculocutaneous flap is presented. Perioperative transfusions that maintained the sickle hemoglobin S level below 30% were crucial in preventing erythrocyte sickling in the microcirculation of the flap during the period of relative ischemia.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, GA, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Hawes
authors.forename: G W
authors.initials: GW
authors.lastname: Carlson
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications*; D001943:Breast Neoplasms / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D000075202:Contraindications; D005260:Female; D006801:Humans; D016462:Mammaplasty; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D013524:Surgical Flaps / Q000379:methods