title: Immediate autologous breast reconstruction using muscle-sparing TRAM flaps with superficial epigastric system turbocharging: a salvage option.
abstract: Current breast reconstruction trends favor the use of muscle-sparing abdominal flaps to minimize abdominal morbidity. When compared to the transverse rectus abdominis myocutaneous (TRAM) flap, the muscle-sparing deep inferior epigastric perforator (DIEP) flap and the superficial inferior epigastric artery (SIEA) flap are common options that minimize donor-site morbidity. For patients with inadequate flap perfusion via either system, alternative surgical options that permit preservation of the abdominal musculature are limited. Using both the DIEP and SIEA systems, the authors describe a turbocharged construct that also facilitates flap perfusion without the need for violation of the anterior rectus sheath. This turbocharged system can provide adequate blood supply in a flap with questionable DIEP or SIEA perfusion alone.
authors.affiliation: University of Chicago Hospitals, Section of Plastic and Reconstructive Surgery, Department of Surgery, 5841 South Maryland Avenue, Chicago, IL 60637, USA
authors.forename: Al B
authors.initials: AB
authors.lastname: Cohn
authors.forename: Robert L
authors.initials: RL
authors.lastname: Walton
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods; D016462:Mammaplasty / Q000379:methods*; D015411:Mastectomy, Modified Radical; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D017568:Rectus Abdominis / Q000098:blood supply* / Q000637:transplantation; D012039:Regional Blood Flow; D018570:Risk Assessment; D016879:Salvage Therapy; D013524:Surgical Flaps / Q000098:blood supply; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology