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Semin Plast Surg 1999; 13(4): 1-15
DOI: 10.1055/s-2008-1080228
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© 1999 by Thieme Medical Publishers, Inc.

Autogenous Tissue Breast Reconstruction: Pedicled or Free TRAM flap?

Mark A. Schusterman, Dean Page, Reza Sadrian
  • M.A.S., Plastic Surgeon in Private Practice, Cosmetic and Reconstructive Plastic Surgery; Clinical Professor of Plastic Surgery, Baylor College of Medicine, Houston, TX
  • D.P., Microsurgery Fellow, St. Luke's Episcopal Hospital, Houston, TX
  • R.S., Resident, Division of Plastic Surgery, Baylor College of Medicine, Houston, TX
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Publication History

Publication Date:
19 June 2008 (online)

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ABSTRACT

The TRAM flap is well accepted as the standard for autogenous tissue breast reconstruction. Controversy continues however, as to whether the pedicled TRAM flap or the free TRAM flap is the better method of transfer. The free TRAM flap is better perfused than the pedicled version, but the risk of vessel thrombosis and total flap loss cause many surgeons to regard the free TRAM flap as too risky to perform on a regular basis. Furthermore, many believe that the pedicled TRAM flap has few complications despite the diminished perfusion. This paper provides the rationale for use of the free TRAM flap, especially for immediate breast reconstruction, and gives technical guidelines for performing the free TRAM flap, which minimizes the chance for vessel thrombosis.

Keywords

TRAM - breast reconstruction - microsurgery - free flap

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