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Preoperative TRAM Free Flap Volume Estimation for Breast Reconstruction in Lean Patients

Cited 21 time in Web of Science Cited 20 time in Scopus
Issue Date
2010-04
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
ANNALS OF PLASTIC SURGERY; Vol.64 4; 397-401
Keywords
TRAM free flappreoperative volume estimationdonor site morbiditylean patients
Abstract
To obtain pleasing symmetry in breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) free flap, a large amount of abdominal flap is elevated and remnant tissue is trimmed in most cases. However, elevation of abundant abdominal flap can cause excessive tension in donor site closure and increase the possibility of hypertrophic scarring especially in lean patients. The TRAM flap was divided into 4 zones in routine manner; the depth and dimension of the 4 zones were obtained using ultrasound and AutoCAD (Autodesk Inc., San Rafael, CA), respectively. The acquired numbers were then multiplied to obtain an estimate of volume of each zone and the each zone volume was added. To confirm the relation between the estimated volume and the actual volume, authors compared intraoperative actual TRAM flap volumes with preoperative estimated volumes in 30 consecutive TRAM free flap breast reconstructions. The estimated volumes and the actual elevated volumes of flap were found to be correlated by regression analysis (r = 0.9258, P < 0.01). According to this result, we could confirm the reliability of the preoperative volume estimation using our method. Afterward, the authors applied this method to 7 lean patients by estimation and revision of the design and obtained symmetric results with minimal donor site morbidity. Preoperative estimation of TRAM flap volume with ultrasound and AutoCAD (Autodesk Inc.) allow the authors to attain the precise volume desired for elevation. This method provides advantages in terms of minimal flap trimming, easier closure of donor sites, reduced scar widening and symmetry, especially in lean patients.
ISSN
0148-7043
Language
English
URI
https://hdl.handle.net/10371/78181
DOI
https://doi.org/10.1097/SAP.0b013e3181b143ef
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College of Medicine/School of Medicine (의과대학/대학원)Plastic Surgery (성형외과학전공)Journal Papers (저널논문_성형외과학전공)
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