Summary
Background
At long-term follow up we cannot easily differentiate between patients who have undergone
free transverse rectus abdominis musculocutaneous (TRAM) flap and deep inferior epigastric
artery perforator (DIEP) flap breast reconstruction in terms of subjective functional
limitations of daily activities. The aim of this study was to evaluate postoperative
outcomes and long-term subjective functional deficit in patients following unilateral
free TRAM compared with DIEP flap breast reconstruction.
Methods
Sixty consecutive patients who underwent unilateral autologous breast reconstruction
were included in the study, 30 of whom had undergone a DIEP flap, and 30 a free TRAM
flap. Surgical and postoperative outcome data were collected and a postal questionnaire
was sent to each patient at least 6 months postoperatively consisting of a short functional
assessment questionnaire and a Short Form 36 (SF-36) survey.
Results
We found no significant difference in postoperative outcomes or in the subjective
ability to perform activities of daily living, including work, domestic activities,
sports and hobbies, between patients who underwent TRAM flap breast reconstruction
and those who underwent a DIEP flap, and no significant difference between the groups
for scores on the physical functioning, role-physical, or bodily pain scales of the
SF-36.
Conclusion
We conclude that harvesting of the free TRAM flap results in no significant difference
in postoperative outcomes or in the subjective ability to perform activities of daily
living compared with the DIEP flap.
Keywords
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References
- The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction.Br J Plast Surg. 1997; 50: 322
- SF-36 health survey update.Spine. 2000; 25: 3130-3139
- Short Form 36 (SF-36) Health Survey questionnaire: which normative data should be used? Comparisons between the norms provided by the Omnibus Survey in Britain, the Health Survey for England and the Oxford Healthy Life Survey.J Public Health Med. 1999; 21: 255-270
- A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap.Br J Plast Surg. 2000; 53: 578
- Comparison of donor-site complications and functional outcomes in free muscle-sparing TRAM flap and free DIEP flap breast reconstruction.Plast Reconstr Surg. 2006; 117: 737-746
- Update on breast reconstruction using free TRAM, DIEP, and SIEA flaps.Semin Plast Surg. 2004; 18: 97-104
Article info
Publication history
Published online: August 28, 2007
Accepted:
July 9,
2007
Received:
January 10,
2007
Identification
Copyright
© 2007 Published by Elsevier Inc.
