The Clinical Investigation Of Small Fascia Patch Technique In One Stage Breast Reconstruction Using Transverse Rectus Abdominis Musculocutaneous Flap

Objective: Small Fascia Patch Transverse rectus abdominis musculocutaneous flaps were performed immediately after mastectomy as an approach to breast reconstruction, and the ways to decrease abdominal hernia and abdominal bulging after TRAM flap was discussed.Methods: From May 2002 to March 2004, 16 women diagnosed with breast cancer (4 in stage I, 5 in stage II and 7 in stage III) have had mastectomy and immediate TRAM flap breast reconstruction done using Small Fascia Patch TRAM flaps. Of the 16 cases, 6 had strong demand to breast reconstruction, 4 had difficulties in wound-closing, and 6 haddifficult wound-closings as well as the demands of body contour rebuilding.Results: TRAM flaps were performed in 16 patients, 7 were done with left side pedicles, 8 with right side pedicles, and 1 with bilateral pedicle. Of the 15 cases with single pedicles, anterior rectus sheath defects varied from 4cm to 7 cm,(averaged 5.6cm). All the defects were simply sutured together without any difficulty. There were no flap losses. 13 patients were satisfied or very satisfied. Only 1 case suffered with abdominal bulging as postoperative complication.Conclusions: Small Fascia Patch TRAM flap is a nice and refined operation for immediate breast reconstruction after mastectomy, not only had the same postoperative result as traditional TRAM flap, but also decreased the abdominal wall complications. And for most of the plastic surgeons, the method we mentioned is not difficult to perform with, and worth popularizing clinically.