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 and ligating neurovascular pedicles to denervate the rectus muscle, preventing postoperative pain. An incision is made in the medial rectus sheath to raise the TRAM flap, which is then rotated 90 degrees and transferred to reconstruct the breast via the superior epigastric vessels. The flap is inset, with partial deepithelialization deferred until abdominal closure impacts traction. Abdomen closure may involve primary suturing or synthetic mesh to reduce pain and distortion. Drains are placed in both the reconstruction site and abdominal area to manage fluid postoperatively.

Keywords

TRAM flap

rectus muscle

neurovascular pedicles

breast reconstruction

postoperative care

rectus muscle denervation

superior epigastric vessels

abdominal closure