A Safe and Efficient Technique for Pedicled TRAM Flap Breast Reconstruction | Journal Article CME-Journal Article CME: A Safe and Efficient Technique for Pedicled TRAM Flap Breast Reconstruction v5

Journal Article CME: A Safe and Efficient Technique for Pedicled TRAM Flap Breast Reconstruction v5

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The procedure involves extending a lateral incision to the costal margin, ligating lateral segmental neurovascular pedicles, and denervating the rectus muscle. The superior segment is innervated by the eighth intercostal nerve, which is ligated to prevent postoperative pain. The rectus muscle is transected, and a TRAM flap is transferred with the superior epigastric vessel supplying it. After ensuring the flap's alignment over the mastectomy defect, the abdominal closure is completed using primary closure or synthetic mesh. The new breast mound is secured, and drains are placed at the reconstruction and abdominal sites to manage postoperative fluid accumulation.

Keywords

TRAM flap

rectus muscle

neurovascular pedicles

breast reconstruction

postoperative care