title: [Breast reconstruction with a TRAM flap].
abstract: OBJECTIVE
  Breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) flap was performed to enhance the mental and physical well-being of patients.
  
  
  METHODS
  The experience with TRAM breast reconstruction in 42 patients was reviewed. The patient selection, flap design and our operative technique were introduced in detail.
  
  
  RESULTS
  TRAM breast reconstruction was performed as immediate reconstruction in 25 patients, as delayed reconstruction in 17 cases. 2 cases had partial skin necrosis in the abdominal donor site. 2 had partial necrosis of the TRAM flap. One patient had abdominal hernia.
  
  
  CONCLUSIONS
  The additional vascular anastomosis or double-pedicle TRAM flap with intramuscular dissection was the key points to reduce complications. Due to the difficulty of TRAM flap reconstruction, thorough understanding of the technique and surgical accuracy are necessary for both flap safety and aesthetic pleasing results.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032, China.
authors.forename: F
authors.initials: F
authors.lastname: Qi
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Gu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017568:Rectus Abdominis / Q000637:transplantation; D013524:Surgical Flaps