title: Breast reconstruction with single-pedicle TRAM flap in breast cancer patients with low midline abdominal scar.
abstract: Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is challenging in patients with low midline abdominal scar. In this study, we aimed to investigate the clinical feasibility of immediate breast reconstruction using single-pedicle TRAM (SP-TRAM) flaps in patients with low midline abdominal scar. There were 4 strict selection criteria: 1) presence at least 3 perforators on the pedicle side; 2) perforators with regional average flow velocity of >20 cm/s; 3) upper edge of the abdominal scar at least 4 cm from the umbilicus; and 4) scar age >1 year. Eight breast cancer patients with low midline abdominal scar (scar group) and 20 without (control group) underwent immediate breast reconstruction with SP-TRAM flaps consisting of zone I and III and zone II tissues. Flap complications, donor-site complications, and cosmetic results were compared between the two groups. All flaps survived and both groups presented similar flap and donor site complications, including fat necrosis, seroma, hematoma, infection, delayed wound healing, and abdominal hernia, and patients in both groups had similar aesthetic results (p > 0.05). Thus, the study demonstrated that breast reconstruction using SP-TRAM flap was a safe approach in carefully selected patients with low midline abdominal scar.
authors.affiliation: The Breast Center, Cancer Hospital of Shantou University Medical College, 7 Raoping Rd. Shantou 515041, Guangdong, China.
authors.forename: Jun-Dong
authors.initials: JD
authors.lastname: Wu
authors.affiliation: The Breast Center, Cancer Hospital of Shantou University Medical College, 7 Raoping Rd. Shantou 515041, Guangdong, China.
authors.forename: Wen-He
authors.initials: WH
authors.lastname: Huang
authors.affiliation: The Breast Center, Cancer Hospital of Shantou University Medical College, 7 Raoping Rd. Shantou 515041, Guangdong, China.
authors.forename: Si-Qi
authors.initials: SQ
authors.lastname: Qiu
authors.affiliation: The Breast Center, Cancer Hospital of Shantou University Medical College, 7 Raoping Rd. Shantou 515041, Guangdong, China.
authors.forename: Li-Fang
authors.initials: LF
authors.lastname: He
authors.affiliation: The Breast Center, Cancer Hospital of Shantou University Medical College, 7 Raoping Rd. Shantou 515041, Guangdong, China.
authors.forename: Cui-Ping
authors.initials: CP
authors.lastname: Guo
authors.affiliation: The Breast Center, Cancer Hospital of Shantou University Medical College, 7 Raoping Rd. Shantou 515041, Guangdong, China.
authors.forename: Yong-Qu
authors.initials: YQ
authors.lastname: Zhang
authors.affiliation: Changjiang Scholar's Laboratory, Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: The Breast Center, Cancer Hospital of Shantou University Medical College, 7 Raoping Rd. Shantou 515041, Guangdong, China.|Changjiang Scholar's Laboratory, Cancer Hospital of Shantou University Medical College, Guangdong, China.
authors.forename: Guo-Jun
authors.initials: GJ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D002921:Cicatrix / Q000150:complications*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D017568:Rectus Abdominis / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects; D016896:Treatment Outcome