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.
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.
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.
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Published online: January 20, 2007
Accepted: July 22, 2006
Received: May 29, 2006
☆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.
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.