Dr.Tarek Said's Scientific Publications

Superdrained Transverse Rectus Abdominis Myocutaneous Flap: A Gold Standard for Immediate Breast Reconstruction??

Adel M. Wilson, M.D. FRCS.; Samy M.I. Said M.D., and Tarek A. Said, M.D.

The Plastic Surgery Department, Faculty of Medicine, Cairo University.

Med. J. Cairo Univ., Vol (71), No (4),(Suppl), Dec.: 11-19, 2003

Pedicled transverse rectus abdominis myocutaneous (TRAM) flaps have been used with an increasing frequency in immediate breast reconstruction following mastectomy. The high incidence of venous compromise and partial flap necrosis rendered the outcome unsatisfactory in several patients. Cadaver studies that demonstrated presence of valves in the inferior epigastric vein that impede retrograde flow, led to the logic modification of performing a supradrainage augmentation of that vein into the thoracodorsal vein.
In the present study 20 conventional contralateral TRAM flaps were used as a primary procedure for breast reconstruction with  supradrainage augmentation. The 90% success rate suggests that this procedure that constitutes very little additional operative renders the surgery much safer and markedly improves flap survival. It is strongly recommended to done in all TRAM reconstructions.

Key words: TRAM - Breast reconstruction

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