eMedicine Specialties > Plastic Surgery > Breast
Breast Reconstruction, Bipedicled TRAM: Workup
Updated: Oct 16, 2008
Workup
Laboratory Studies
- Consultation is required for the patient to understand the magnitude of the intended procedure. Discussion should include possible complications and necessary scars, and the patient should have the opportunity to view pictures of an average TRAM flap result. Some patients find it helpful to speak to a prior patient who was once in a similar situation. Answer all questions to give the patient realistic expectations. Preoperative laboratory examination is directed by the patient's medical condition. At minimum, perform the following:
- CBC count
- Electrolytes
- Urinalysis
- Chest radiograph
- ECG
- Type and screen
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References
Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. Feb 1982;69(2):216-25. [Medline].
Bostwick J. Abdominal flap reconstruction. In: Plastic and Reconstructive Breast Surgery. 2nd ed. St Louis, Mo: Quality Medical Publishing Inc; 2000:981-1146.
Dulin WA, Avila RA, Verheyden CN, et al. Evaluation of abdominal wall strength after TRAM flap surgery. Plast Reconstr Surg. May 2004;113(6):1662-5; discussion 1666-7. [Medline].
Hartrampf CR Jr. The transverse abdominal island flap for breast reconstruction. A 7- year experience. Clin Plast Surg. Oct 1988;15(4):703-16. [Medline].
Lejour M, Dome M. Abdominal wall function after rectus abdominis transfer. Plast Reconstr Surg. Jun 1991;87(6):1054-68. [Medline].
Moon HK, Taylor GI. The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep superior epigastric system. Plast Reconstr Surg. Nov 1988;82(5):815-32. [Medline].
Ng RL, Youssef A, Kronowitz SJ, et al. Technical variations of the bipedicled TRAM flap in unilateral breast reconstruction: effects of conventional versus microsurgical techniques of pedicle transfer on complications rates. Plast Reconstr Surg. Aug 2004;114(2):374-84; discussion 385-8. [Medline].
Shaw WW, Orringer JS, Ko CY, et al. The spontaneous return of sensibility in breasts reconstructed with autologous tissues. Plast Reconstr Surg. Feb 1997;99(2):394-9. [Medline].
Shestak KC. Bipedicle TRAM flap reconstruction. In: Spear SL, ed. Surgery of the Breast: Principles and Art. 2nd ed. Philadelphia, Pa: Lippincott-Raven; 2006:719-31.
Simon AM, Bouwense CL, McMillan S, et al. Comparison of unipedicled and bipedicled TRAM flap breast reconstructions: assessment of physical function and patient satisfaction. Plast Reconstr Surg. Jan 2004;113(1):136-40. [Medline].
Zienowicz RJ, May JW Jr. Hernia prevention and aesthetic contouring of the abdomen following TRAM flap breast reconstruction by the use of polypropylene mesh. Plast Reconstr Surg. Nov 1995;96(6):1346-50. [Medline].
Further Reading
Keywords
TRAM flap, transverse rectus abdominus myocutaneous flap, breast surgery, breast reconstruction, breast flap, bipedicled, autogenous tissue
Workup: Breast Reconstruction, Bipedicled TRAM