J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3000KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 100(9): 547-550, 1999

Feature topic

TRAM FLAP BREAST RECONSTRUCTION USING A FASCIA-SPARING TECHNIQUE

1) Soshundo Plastic Surgery, Sapporo, Japan
2) Department of Surgery, Keiyukai Sapporo Hospital, Sapporo, Japan
3) Department of Plastic and Reconstructive Surgery, Hokkaido University School of Medicine, Sapporo, Japan

Kunihiko Nohira1), Yoshihisa Shintomi1), Masao Hosokawa2), Kazunori Yajima3), Satoru Sasaki3), Yuhei Yamamoto3), Tsuneki Sugihara3)

Although the TRAM flap has been accepted as one of the most common methods for breast reconstruction utilizing the autologous tissue, its disadvantage is that scarring of the abdominal sheath and muscle may result in postoperative abdominal bulge or hernia. To solve this problem, the authors developed the fasciasparing technique in TRAM flap breast reconstruction. The technique, in which most of the anterior rectus sheath is preserved, has been applied in 3 patients after radical mastectomy and 7 patients after modified radical mastectomy. With an average follow-up period of 1 year and 2 months, no abdominal bulge or hernia was noted in any patient without the use of prosthetic mesh for the abdominal closure.
This fascia sparing technique is particularly effective for TRAM flap reconstruction requiring bilateral rectus abdominis muscle portions and containing only a few minor perforators, for which a DIEP flap is not stuitable.

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