eMedicine Specialties > Plastic Surgery > Breast

Breast Reconstruction, Bipedicled TRAM: Workup

Author: Michael R Zenn, MD, FACS, Associate Professor, Division of Plastic and Reconstructive Surgery, Program Director of Plastic Surgery Residency, Duke University Medical Center
Contributor Information and Disclosures

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

More on Breast Reconstruction, Bipedicled TRAM

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Treatment: Breast Reconstruction, Bipedicled TRAM
Multimedia: Breast Reconstruction, Bipedicled TRAM
References

References

  1. Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. Feb 1982;69(2):216-25. [Medline].

  2. Bostwick J. Abdominal flap reconstruction. In: Plastic and Reconstructive Breast Surgery. 2nd ed. St Louis, Mo: Quality Medical Publishing Inc; 2000:981-1146.

  3. 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].

  4. 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].

  5. Lejour M, Dome M. Abdominal wall function after rectus abdominis transfer. Plast Reconstr Surg. Jun 1991;87(6):1054-68. [Medline].

  6. 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].

  7. 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].

  8. 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].

  9. 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.

  10. 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].

  11. 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

Contributor Information and Disclosures

Author

Michael R Zenn, MD, FACS, Associate Professor, Division of Plastic and Reconstructive Surgery, Program Director of Plastic Surgery Residency, Duke University Medical Center
Michael R Zenn, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American College of Surgeons, American Medical Association, American Society for Reconstructive Microsurgery, American Society of Plastic Surgeons, North Carolina Medical Society, Phi Beta Kappa, Plastic Surgery Research Council, Southeastern Society of Plastic and Reconstructive Surgeons, and World Society for Reconstructive Microsurgery
Disclosure: Nothing to disclose.

Medical Editor

Pankaj Tiwari, MD, Assistant Professor, Division of Plastic Surgery, Ohio State University
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Saleh M Shenaq, MD†, Former Director and Founder, The International Brachial Plexus Institute; Former Chief, Section of Plastic Surgery, Methodist Hospital, Houston
Saleh M Shenaq, MD† is a member of the following medical societies: American Academy of Anti-Aging Medicine, American Academy of Pediatrics, American Association for Hand Surgery, American Association for the Advancement of Science, American Association of Plastic Surgeons, American Burn Association, American College of Physician Executives, American College of Surgeons, American Congress of Rehabilitation Medicine, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, American Society of Gene Therapy, American Society of Law Medicine and Ethics, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Trauma Society, Association for Academic Surgery, International College of Surgeons, Lipoplasty Society of North America, Plastic Surgery Research Council, Society for Neuroscience, Society of Surgical Oncology, Southern Medical Association, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Director, Colorado Plastic Surgery Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Al Aly, MD, FACS, Consulting Surgeon, Iowa City Plastic Surgery
Disclosure: Ethicon  Consulting fee Consulting; QMP Royalty Book royalty; Insorb Stapler Consulting fee Consulting; Insorb Stapler Ownership interest None; Medicis Intellectual property rights None

 
 
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