Revista Brasileira de Cirurgia Plástica (Mar 2021)

Systematization of reconstruction of the abdominal wall after reconstruction with TRAM

  • Armando dos Santos cunha,
  • Rafael Sabino Caetano Costa,
  • José Carlos Daher,
  • Suellen Vieira da Silva,
  • Carolina Oliveira Paranaguá de Castro,
  • Anderson de Azevedo Damasio,
  • Amanda Costa Campos,
  • Phabio Claudino Estrela Terra Theodoro

DOI
https://doi.org/10.5935/2177-1235.2021RBCP0004
Journal volume & issue
Vol. 36, no. 01
pp. 15 – 20

Abstract

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Introduction: Tram (transverse abdominal rectum flap) has remained the most used autologous breast reconstruction method over the last 30 years. First described by Holmström, the flap allows breast reconstruction with analogous tissue, providing natural appearance and consistency and lasting results. Reconstruction of the abdominal wall of the defect installed after flap transposition is a major challenge, and there is no consensus on the form for elevation or closure of the abdominal wall flap. The article aims to present a practical method for abdominal wall reconstructions to reduce morbidity in patients undergoing breast reconstruction with TRAM. Methods: This is a descriptive work of a systematic abdominal wall reconstruction technique using propylene mesh. Result: Once the technique is applied, we have an abdominal wall covered with polypropylene fabric, fully fixed and well adapted. The systematization of abdominal wall reconstruction after reconstruction with TRAM was performed, which is characterized by being easy to reproduce and applicable. Conclusion: The technique is a good alternative in abdominal wall reconstructions for the surgeon, systematizing polypropylene mesh adaptation.

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