▪ ABSTRACT
Introduction:
The transverse rectus abdominis muscle flap (TRAM) is a method of breast
reconstruction with good aesthetic results and does not require the use of
silicone implants for better body contouring. It was originally described by
Holmstrom in 1979 as an ellipse of skin and fat based on an isolated muscle
on its vascular pedicle. The systematic reconstruction of the wall defect
installed after flap transposition using polypropylene mesh was described in
a previous study by Cunha. The article aims to evaluate changes in the
abdominal wall, after the systematization of polypropylene mesh placement
during TRAM reconstruction surgery.
Method:
This is a retrospective cohort study that evaluates possible changes in the
abdominal wall of patients undergoing the TRAM flap with preand
postoperative abdominal computed tomography.
Results:
A reduction in the size of the abdominal cavity of, on average, 14.5% and
14.2% in the thickness of the abdominal wall subjected to TRAM was
evidenced. The greatest reduction in abdominal wall thickness was in a
patient who underwent a bipedicled flap, with 50.7%. The complications
presented were umbilical hernia, late seroma, perithellal fibrosis, and
thread granuloma.
Conclusion:
In this study, tomography after surgery demonstrated a reduction in the
volume of the abdominal cavity and thickness of the abdominal wall, which
did not statistically influence the appearance of abdominal hernia, bulging,
mesh extrusion, or other deformities.
Keywords: Mammaplasty - Abdominal wall - Abdominal cavity - Myocutaneous flap - Abdominal muscles
Bibliographical Record
