PATIENT SELECTION AND TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP COMPLICATIONS
A LITERATURE REVIEW
Keywords:
Myocutaneous flap, breastAbstract
Introduction: Breast cancer is the most prevalent malignant neoplasm in women. Due to delayed diagnosis, a modified radical mastectomy is the surgical treatment of choice for a large proportion of patients with the disease. Breast reconstruction with myocutaneous flaps is the technique that offers the best long-term results. The TRAM (transverse rectus abdominis myocutaneous) technique has been improved in the last 30 years, and its main advantage is its use of large volumes, which gives the new breast contour and a more natural consistency. Objective: Review the literature on the reconstruction technique with the TRAM flap, focusing on technique, patient selection and the main complications. Results: The main indications regarding reconstruction with TRAM refer to cases with extensive defects after immediate or delayed mastectomy, or when there are major consequences from radiotherapy or failure in other reconstructions. Strict criteria must be adopted in the selection of these patients, especially with regard to their comorbidities. The proper selection of patients can reduce a series of complications arising from the method. Conclusion: TRAM is an excellent option for immediate or delayed breast reconstruction as long as the patients are well selected. It eliminates (or at least reduces) the need for implants and their possible implications and additionally gives a more natural format to the reconstructed breast by accompanying the patient’s weight fluctuations. However, this technique is not free of complications, especially with regard to donor areas and the patient’s need for longer surgical and recovery time.
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Copyright (c) 2017 Raissa Cruz Oliveira, Douglas de Miranda Pires, Carolina Nazareth Valadares, Guilherme Junqueira Souza, Mariana dos Santos Nascimento, Ana Carolina Guglielmelli Mendonça
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