title: The abdominal fascial closure in a double-breasted jacket pattern following a TRAM free flap breast reconstruction.
abstract: The primary closure of abdominal fascia after breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap has been reported to be the most effective way to reduce these complications. A total of 108 patients who underwent immediate unilateral breast reconstruction with muscle-sparing TRAM flap were included in the study. We compared complications between 56 patients who underwent conventional primary fascial closure (group 1) and 52 who underwent fascial closure in a new double-breasted jacket pattern (group 2), retrospectively. Abdominal bulging occurred in four patients (7.1%) in group 1 and one patient (1.9%) in group 2 (p = 0.01). An abdominal wound dehiscence occurred in three (5.4%) patient in group 1 and two (3.8%) patient in group 2 (p = 0.12). After conventional or muscle-sparing TRAM free flap reconstruction, closing the abdominal fascia in a double-breasted jacket pattern can help reinforce the lower abdominal fascia and prevent abdominal bulging caused by abdominal fascia tensional imbalance.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Han-Su
authors.initials: HS
authors.lastname: Yoo
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Hong
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dae hyun
authors.initials: Dh
authors.lastname: Lew
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tai Suk
authors.initials: TS
authors.lastname: Roh
mesh_terms: D058107:Abdominal Wound Closure Techniques; D000328:Adult; D005205:Fascia / Q000637:transplantation*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D017568:Rectus Abdominis / Q000637:transplantation*; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome