Summary
Background
Today, breast reconstruction with autologous tissue is most commonly done either as
a free muscle sparring TRAM flap or as a DIEP flap. Studies of donor site morbidity
have shown an advantage in using the DIEP flap. However, this procedure might also
be associated with an increased risk of flow related complications and it is also
thought to be more demanding and time consuming. A few studies have evaluated the
abdominal wall strength after dissection of a TRAM flap or a DIEP flap. However, these
studies do not distinguish between the various types of free TRAM flaps and they also
compare TRAM procedures preformed in an early period to DIEP procedures done in a
later period.
Methods
We used an isokinetic dynamometer to measure concentric, eccentric and isometric abdominal
muscle strength in 32 patients who had had a unilateral breast reconstruction with
a free MS-2 (15) or a DIEP (17) flap in the year 2003.
Results
No significant reduction in muscle strength was observed for concentric or isometric
muscle strength. However, significant lower eccentric muscle strength was found in
the TRAM compared to the DIEP group (p=0.05).
There was no significant difference in abdominal strength between the two flap groups
at low to moderate work intensity (isometric/concentric). At the greatest work intensity
(eccentric muscle strength) the patients reconstructed with a DIEP flap had a clinical
small, but significant advantage over the patients reconstructed with a MS-2 TRAM
flap.
Keywords
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References
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Article info
Publication history
Published online: January 20, 2007
Accepted:
July 22,
2006
Received:
May 29,
2006
Footnotes
☆Presented at the 2006 Annual Scientific meeting of the American Society for Reconstructive Microsurgery, Loews Ventana Canyon Resort, Tucson, AZ, USA. January 14–17, 2006.
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
