title: [Morbidity of the abdominal wall after breast reconstruction and elective abdominoplasty].
abstract: BACKGROUND
  The free TRAM flap is commonly used in breast reconstruction after mastectomy. Donor-site morbidity of the abdominal wall is usually determined by scars, loss of sensation and functional restrictions. Similar aesthetic and functional problems are described for patients after elective abdominoplasty. Is morbidity of the abdominal wall after breast reconstruction based on muscle lesions or on the trauma from operation?
  
  
  METHODS
  21 patients after breast reconstruction and 20 patients after elective abdominoplasty were evaluated concerning the aesthetic results, scars and herniasation. Satisfaction with the result was assessed. In addition, the function of the abdominal wall was noted according to Janda.
  
  
  RESULTS
  The postoperative course was uneventful. Three cases after elective abdominoplasty developed a recurrence of rectus muscle diastasis. After breast reconstruction there was one hernia and one patient showed a rectus diastasis. Loss of sensation, functional and aesthetic problems were seen in both groups.
  
  
  CONCLUSIONS
  There are no statistic significant differences between elective abdominoplasty and abdominoplasty after breast reconstruction. In both groups loss of sensation, functional and aesthetic problems were noted. Even in elective abdominoplasty there is a loss of function in the abdominal wall. Donor-site morbidity after breast reconstruction is not only caused by the muscle lesion, but the functional and aesthetic problems are due to the general trauma of the abdominal wall.
authors.affiliation: Klinik für Plastische, Wiederherstellungs- und Handchirurgie (Direktor: Prof. Dr. W. Schneider), Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany. silke.altmann@medizin.uni-magdeburg.de
authors.forename: S
authors.initials: S
authors.lastname: Altmann
authors.forename: K
authors.initials: K
authors.lastname: Plogmeier
authors.forename: H
authors.initials: H
authors.lastname: Fansa
authors.forename: W
authors.initials: W
authors.lastname: Schneider
mesh_terms: D034861:Abdominal Wall / Q000502:physiology* / Q000601:surgery*; D002921:Cicatrix; D004954:Esthetics; D005260:Female; D046449:Hernia, Abdominal / Q000209:etiology; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D013524:Surgical Flaps