title: Impact of prior ipsilateral chest wall radiation on pedicled TRAM flap breast reconstruction.
abstract: BACKGROUND
  This study compares complication rates between transverse rectus abdominis myocutaneous (TRAM) flaps based on previously irradiated versus nonirradiated superior pedicles to assess the impact of prior ipsilateral chest wall radiation on pedicled TRAM flap breast reconstruction.
  
  
  METHODS
  A retrospective study of 302 consecutive TRAM flap reconstructions was performed; 76 TRAM flaps based on a previously irradiated superior epigastric pedicle were compared to 226 TRAM flaps based on a nonirradiated pedicle in medical comorbidities, oncologic data, and complications.
  
  
  RESULTS
  Patients having undergone previous chest wall irradiation had a higher cancer stage, but demographic data were otherwise similar within the groups. Previous chest wall irradiation did not result in increased rate of flap loss, infection, and fat necrosis. However, there was a trend toward higher revision rate in the previously irradiated TRAM group.
  
  
  CONCLUSIONS
  Previous radiation to the superior epigastric pedicle is not associated with a significant increase in flap complications and should be considered a viable modality for pedicled TRAM flap breast reconstruction.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02130, USA. ychun@partners.org
authors.forename: Yoon S
authors.initials: YS
authors.lastname: Chun
authors.forename: Kapil
authors.initials: K
authors.lastname: Verma
authors.forename: Indranil
authors.initials: I
authors.lastname: Sinha
authors.forename: Heather
authors.initials: H
authors.lastname: Rosen
authors.forename: Charles
authors.initials: C
authors.lastname: Hergrueter
authors.forename: Julia
authors.initials: J
authors.lastname: Wong
authors.forename: Julian J
authors.initials: JJ
authors.lastname: Pribaz
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D005218:Fat Necrosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D035441:Thoracic Wall / Q000000981:diagnostic imaging*