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:
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CBC count
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Electrolytes
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Urinalysis
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Chest radiograph
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ECG
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Type and screen
Media Gallery
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Blood supply to bipedicle transverse rectus abdominis myocutaneous (TRAM) flap. Note the bilateral superior epigastric blood supply and the shaded area of the TRAM flap to be discarded.
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Patient 1. This patient has a large breast to match and is not interested in a breast reduction. Note the ample lower abdominal tissues available for reconstruction.
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Patient 1. Postoperative view at 1 year after all stages of reconstruction were complete. Bipedicle transfer allows reliable transfer of a large bulk of lower abdominal tissues to match the large opposite breast. Note the improved abdominal contour, a benefit of the transverse rectus abdominis myocutaneous procedure.
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