Microvascularly augmented transverse rectus abdominis myocutaneous flap for breast reconstruction - Reappraisal of its value through clinical outcome assessment and intraoperative blood gas analysis

Jing-Wei Lee, Yao-Chou Lee, Tsai Wang Chang

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6 Citations (Scopus)

Abstract

Our experience with 73 transverse rectus abdominis myocutaneous (TRAM) flap transfers was reviewed to see the variance in the incidence of complications among three groups of patients undergoing different types of surgical techniques. The TRAM flap was transferred as a free flap in 26 patients, a unipedicled flap in 25 patients, and a microvascularly augmented pedicled flap in 22 patients. Our data demonstrated that the incidence of partial flap loss and fat necrosis in the microvascularly augmented group was significantly lower than that in the unipedicled flap group (P < 0.01), and also lower than that in the free flap group with a statistically marginal significance (P = 0.055). Supplemental surgery is less often required in the microvascularly augmented group than in the conventional TRAM group (P = 0.002). Substantial increase in venous O2 concentration (P = 0.03), O2 saturation level (P 5 0.007), and pH value (P 5 0.002) was noticed following supercharge, and this very fact testifies to the perfusion-promoting effect of the microvascular augmentation maneuver.

Original languageEnglish
Pages (from-to)656-662
Number of pages7
JournalMicrosurgery
Volume28
Issue number8 SPEC. ISS
DOIs
Publication statusPublished - 2008 Nov 18

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Rectus Abdominis
Blood Gas Analysis
Myocutaneous Flap
Mammaplasty
Outcome Assessment (Health Care)
Free Tissue Flaps
Fat Necrosis
Surgical Flaps
Incidence
Perfusion

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

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title = "Microvascularly augmented transverse rectus abdominis myocutaneous flap for breast reconstruction - Reappraisal of its value through clinical outcome assessment and intraoperative blood gas analysis",
abstract = "Our experience with 73 transverse rectus abdominis myocutaneous (TRAM) flap transfers was reviewed to see the variance in the incidence of complications among three groups of patients undergoing different types of surgical techniques. The TRAM flap was transferred as a free flap in 26 patients, a unipedicled flap in 25 patients, and a microvascularly augmented pedicled flap in 22 patients. Our data demonstrated that the incidence of partial flap loss and fat necrosis in the microvascularly augmented group was significantly lower than that in the unipedicled flap group (P < 0.01), and also lower than that in the free flap group with a statistically marginal significance (P = 0.055). Supplemental surgery is less often required in the microvascularly augmented group than in the conventional TRAM group (P = 0.002). Substantial increase in venous O2 concentration (P = 0.03), O2 saturation level (P 5 0.007), and pH value (P 5 0.002) was noticed following supercharge, and this very fact testifies to the perfusion-promoting effect of the microvascular augmentation maneuver.",
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AU - Lee, Jing-Wei

AU - Lee, Yao-Chou

AU - Chang, Tsai Wang

PY - 2008/11/18

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N2 - Our experience with 73 transverse rectus abdominis myocutaneous (TRAM) flap transfers was reviewed to see the variance in the incidence of complications among three groups of patients undergoing different types of surgical techniques. The TRAM flap was transferred as a free flap in 26 patients, a unipedicled flap in 25 patients, and a microvascularly augmented pedicled flap in 22 patients. Our data demonstrated that the incidence of partial flap loss and fat necrosis in the microvascularly augmented group was significantly lower than that in the unipedicled flap group (P < 0.01), and also lower than that in the free flap group with a statistically marginal significance (P = 0.055). Supplemental surgery is less often required in the microvascularly augmented group than in the conventional TRAM group (P = 0.002). Substantial increase in venous O2 concentration (P = 0.03), O2 saturation level (P 5 0.007), and pH value (P 5 0.002) was noticed following supercharge, and this very fact testifies to the perfusion-promoting effect of the microvascular augmentation maneuver.

AB - Our experience with 73 transverse rectus abdominis myocutaneous (TRAM) flap transfers was reviewed to see the variance in the incidence of complications among three groups of patients undergoing different types of surgical techniques. The TRAM flap was transferred as a free flap in 26 patients, a unipedicled flap in 25 patients, and a microvascularly augmented pedicled flap in 22 patients. Our data demonstrated that the incidence of partial flap loss and fat necrosis in the microvascularly augmented group was significantly lower than that in the unipedicled flap group (P < 0.01), and also lower than that in the free flap group with a statistically marginal significance (P = 0.055). Supplemental surgery is less often required in the microvascularly augmented group than in the conventional TRAM group (P = 0.002). Substantial increase in venous O2 concentration (P = 0.03), O2 saturation level (P 5 0.007), and pH value (P 5 0.002) was noticed following supercharge, and this very fact testifies to the perfusion-promoting effect of the microvascular augmentation maneuver.

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