Retraction notice to P3: Patient satisfaction and abdominal wall function: TRAM versus DIEP flap breast reconstruction [Eur. J. Surg. Oncol. 38 (2012) 420]

2012 ◽  
Vol 38 (11) ◽  
pp. 1143
Author(s):  
J. Miles ◽  
A. Bajwa ◽  
P. Polson ◽  
C. Muberekwa
Microsurgery ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 352-360 ◽  
Author(s):  
Jonas A. Nelson ◽  
John P. Fischer ◽  
Chen Yan ◽  
Joshua Fosnot ◽  
Jesse C. Selber ◽  
...  

2010 ◽  
Vol 43 (02) ◽  
pp. 166-172
Author(s):  
Chacko Cyriac ◽  
Ramesh Kumar Sharma ◽  
Gurpreet Singh

ABSTRACT Background: The pedicled TRAM flap has been a workhorse of autologous breast reconstruction for decades. However, there has been a rising concern about the abdominal wall donor site morbidity with the use of conventional TRAM flap. This has generally been cited as one of the main reasons for resorting to “abdominal wall friendly” techniques. This study has been undertaken to assess the abdominal wall function in patients with pedicled TRAM flap breast reconstruction. The entire width of the muscle and the overlying wide disk of anterior rectus sheath were harvested with the TRAM flap in all our patients and the anterior rectus sheath defect was repaired by a Proline mesh. Materials and Methods: Abdominal wall function was studied in 21 patients who underwent simultaneous primary unipedicled TRAM flap reconstruction after mastectomy for cancer. In all the patients, the abdominal wall defect was repaired using wide sheet of Proline mesh both as inlay and onlay. The assessment tools included straight and rotational curl ups and a subjective questionnaire. The abdominal wall was also examined for any asymmetry, bulge, or hernia. The minimal follow-up was 6 months postoperative. The objective results were compared with normal unoperated volunteers. Results and Conclusions: The harvesting the TRAM flap certainly results in changes to the anterior abdominal wall that can express themselves to a variable degree. A relatively high incidence of asymptomatic asymmetry of the abdomen was seen. There was total absence of hernia in our series even after a mean follow-up period of 15.5 months. A few patients were only able to partially initiate the sit up movement and suffered an important loss of strength. In most patients, synergists took over the functional movement but as the load increased, flexion and rotation performances decreased. The lack of correlation between exercise tests and the results of the questionnaire suggests that this statistically significant impairment was functionally not important. The patients encountered little or no difficulty in theis day-to-day activities. Our modification of use of a wide mesh as inlay and onlay repair minimizes the donor site morbidity. This also avoids maneuvers meant for primary closure of the rectus sheath defects, which can result in distortion of umbilicus. Therefore, in conclusion, the unipedicled TRAM flap should be regarded as a valuable option in breast reconstruction provided careful repair of the abdominal wall defect is undertaken using Proline mesh.


2009 ◽  
Vol 14 (1) ◽  
pp. 175-185 ◽  
Author(s):  
Michael J. Rosen ◽  
Javairiah Fatima ◽  
Michael G. Sarr

2019 ◽  
Vol 53 (2) ◽  
pp. 119-124
Author(s):  
Berit Kristine Skraastad ◽  
Cathrine Knudsen ◽  
Catherine Jackson ◽  
Tor Paaske Utheim ◽  
Are Hugo Pripp ◽  
...  

2019 ◽  
Vol 65 (4) ◽  
pp. 603-607
Author(s):  
R. Pesotskiy ◽  
P. Kalinin ◽  
Petr Krivorotko ◽  
Andrey Mishchenko ◽  
Konstantin Zernov ◽  
...  

Introduction: deep inferior epigastric perforator flap (DIEP-flap) reconstruction provides the most acceptable aesthetic result among autologous breast reconstruction. However, a thorough preoperative assessment of the individual vascular anatomy of the deep lower epigastric vessels (DIEA/V) is still challlenging. Usage of CT(a) allows define individual anatomical features such as: intramuscular stroke, tortuosity of vessels and their branches which is an essential thing for reducing of the operation time, flap ischemia time, decreasing the complication rate. Material and methods: with the help of Radiology Department, we have launched a new protocol for planning of the DIEP flap surgery. As a preoperative preparation, we perform CT angiography (CTA) according to a specific protocol, which allows us to reduce the trauma of aponeurosis and the rectus abdominis muscle. Сonclusion: preoperative CT angiography, performed according to a special scanning and post-processing protocol, allows us to optimize the planning of the surgical intervention and improving the results of breast reconstruction. Detailed study of the topography of the vessels of the anterior abdominal wall leads to a decrease in tissue injury of the anterior abdominal wall. This article describes the importance of CT angiography, for the preoperative preparation (visualization) as a crucial step in preparing for the DIEP reconstruction of the breast.


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