What is the difference between a TRAM flap and DIEP flap?

Where they differ is in the execution. TRAM flap focuses on using tissue from your abdominal muscles, as well as some soft tissue. DIEP flap spares the abdominal muscle and uses only soft fat tissue and local blood vessels. Each procedure has long recovery times, and similar side effects.

What is a TRAM flap procedure?

A TRAM flap surgery involves moving a section of abdominal muscle along with fat and skin up to the chest. In this procedure, the relocated tissue isn’t cut off from its blood supply. The DIEP flap is more complicated because the new “breast tissue” is freed from the belly.

Is tram a free flap?

TRAM flaps can be used as a pedicled or free flap. The pedicled TRAM was first described by Dr. Hartrampf in 1982.

What muscle is used for the TRAM flap?

transverse rectus abdominis
TRAM stands for transverse rectus abdominis, a muscle in your lower abdomen between your waist and your pubic bone. A flap of this skin, fat, and all or part of the underlying rectus abdominus (“6-pack”) muscle are used to reconstruct the breast in a TRAM flap procedure.

Is TRAM flap like a tummy tuck?

The difference compared to a free TRAM flap is that no muscle is taken from the abdominal wall. The tissue is completely cut free from the tummy and then moved to the chest. As in the free TRAM flap surgery, a microscope is needed to connect the tiny blood vessels.

Is TRAM flap surgery safe?

Among the 168 pedicled TRAM flap procedures in 158 patients, flap complications occurred in 34%. Most of the flap complications included some degree of fat necrosis. There was no total flap loss. Flap complications were associated with elderly patients and the presence of major donor site complications.

Is a TRAM flap a tummy tuck?

In either case, a TRAM flap breast reconstruction uses natural tissue taken from the patient’s own body, rather than artificial silicone breast implants, and can provide the benefits of an abdominoplasty, or tummy tuck, in addition to natural-looking breast reconstruction results.

What are some of the complications for tram surgery?

Measured complications included fat necrosis, mastectomy flap necrosis, abdominal flap necrosis, partial TRAM flap loss, wound infection, hematoma, seroma, vessel thrombosis, and abdominal hernia.

How long does it take to recover from TRAM flap surgery?

What is TRAM flap surgery? The patient requires 6 to 12 weeks to regain prior energy levels and resume normal activities. TRAM stands for Transverse Rectus Abdominis Myocutaneous, a muscle, and tissue of the lower abdomen between the waist and pubic bone.

Does flap surgery hurt?

Most patients experience some discomfort after a flap procedure. Depending on your needs, we may prescribe pain medication or recommend over-the-counter medicine. It is important to relax after surgery, as strenuous activity may cause the treated area to bleed.

Can a TRAM flap be reversed?

No, the TRAM flap surgery cannot be reversed. If you have concerns or complications after a TRAM flap, talk with your plastic surgeon about options to minimize risk or difficulties.

What is a superficial inferior epigastric artery flap?

A flap based specifically on a superficial inferior epigastric artery, because it does not require opening of the rectus sheath, is associated with lower donor site morbidity than either a deep inferior epigastric perforating artery flap or a transverse rectus abdominis myocutaneous flap ( 6 ).

How are vascular microclamps placed to perfuse the epigastric flap?

When the entire flap has been raised, vascular microclamps are placed across the isolated deep inferior epigastric perforating vessels, and only the superficial inferior epigastric artery is left to perfuse the flap.

What are the branching patterns of the deep inferior epigastric artery (die)?

Three branching patterns of the deep inferior epigastric artery have been described: a single trunk, bifurcation, and division into three or more branches ( 11) ( Fig 2 ).

How is perforation of the epigastric artery performed?

After a suitable deep inferior epigastric perforating artery has been identified, an incision is made next to it in the rectus sheath to expose the course of the vessel through the rectus muscle.