Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Simplified Insetting Strategy in Pedicled TRAM Flap Breast Reconstruction

유경 횡복직근피판을 이용한 유방재건술에서 피판장착의 단순화된 전략

  • Lee, Taik Jong (Asan Medical Center, Department of Plastic Surgery, University of Ulsan, College of Medicine) ;
  • Yoon, Sang Yup (Asan Medical Center, Department of Plastic Surgery, University of Ulsan, College of Medicine)
  • 이택종 (울산대학교 의과대학 성형외과학교실) ;
  • 윤상엽 (울산대학교 의과대학 성형외과학교실)
  • Received : 2006.01.24
  • Published : 2006.05.10
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Abstract

Various method of insetting the transverse rectus abdominis myocutaneous flap for breast reconstruction has been reported in literature. The Bostwick's principle is commonly applied, which utilizes contralateral pedicle in a vertical or oblique flap inset position and ipsilateral pedicle in the transverse position. But it is relatively a complex and difficult technique, thus requires a more simplified strategy. We have formulated a new insetting method, in which the contralateral pedicled TRAM flap with an oblique($0^{\circ}-90^{\circ}$) flap inset was carried out. We used this method in 100 cases from July 2001 to June 2003. This maneuver places Hartrampf's zones I and III with good vascularity in the medial side, and zone II in lateral side of breast. Fat necrosis was observed in 14 patients(14%) and of these, only three cases needed surgical excision. This simplified method is easy to learn. Specifically, fat necrosis removal is easy with more tolerable aesthetic results, especially in Asian patients with smaller breasts.

Keywords

References

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