Abstract
The transverse abdominal island flap operation was the method of breast reconstruction after mastectomy and in chest wall reconstruction in 300 patients from September 1980 to July 1986. In 58% (221 of 383 breast reconstructions), the breast mound was formed in a single operation and required no further revision. Only 18 reconstructed breasts required modification after 1 year. Symmetry was achieved without altering the opposite breast in 113 (52% of the 217 unilateral reconstructions). Complications included one total flap loss (0.3%) and 18 partial flap losses (6%). There was one lower abdominal hernia (0.3%) and two small defects in the upper anterior rectus sheath (0.8%). Lower abdominal wall laxity occurred in two patients (0.8%), one requiring repair. As expected, there was some loss of abdominal wall strength after reconstruction but this did not affect sports or work performance in over 90% of patients. Ninety-eight per cent of respondents (272 or 278) judged the operation worth their time and effort. This major operative procedure is indicated only in healthy patients.
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- Drever J. M., Hodson-Walker N. Closure of the donor defect for breast reconstruction with rectus abdominis myocutaneous flaps. Plast Reconstr Surg. 1985 Oct;76(4):558–565. doi: 10.1097/00006534-198510000-00013. [DOI] [PubMed] [Google Scholar]
- Finseth F., Adelberg M. G. Experimental work with isoxuprine for prevention of skin flap necrosis and for treatment of the failing flap. Plast Reconstr Surg. 1979 Jan;63(1):94–100. doi: 10.1097/00006534-197901000-00015. [DOI] [PubMed] [Google Scholar]
- Finseth F., Adelberg M. G. Prevention of skin flap necrosis by a course of treatment with vasodilator drugs. Plast Reconstr Surg. 1978 May;61(5):738–743. doi: 10.1097/00006534-197805000-00013. [DOI] [PubMed] [Google Scholar]
- Hartrampf C. R., Jr Abdominal wall competence in transverse abdominal island flap operations. Ann Plast Surg. 1984 Feb;12(2):139–146. doi: 10.1097/00000637-198402000-00008. [DOI] [PubMed] [Google Scholar]
- Hartrampf C. R., Scheflan M., Black P. W. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. 1982 Feb;69(2):216–225. doi: 10.1097/00006534-198202000-00006. [DOI] [PubMed] [Google Scholar]
- Ishii C. H., Jr, Bostwick J., 3rd, Raine T. J., Coleman J. J., 3rd, Hester T. R. Double-pedicle transverse rectus abdominis myocutaneous flap for unilateral breast and chest-wall reconstruction. Plast Reconstr Surg. 1985 Dec;76(6):901–907. doi: 10.1097/00006534-198512000-00019. [DOI] [PubMed] [Google Scholar]
- Mes L. G. Improving flap survival by sustaining cell metabolism within ischemic cells: a study using rabbits. Plast Reconstr Surg. 1980 Jan;65(1):56–65. doi: 10.1097/00006534-198001000-00011. [DOI] [PubMed] [Google Scholar]
- Pressman P. I. Selective biopsy of the opposite breast. Cancer. 1986 Feb 1;57(3):577–580. doi: 10.1002/1097-0142(19860201)57:3<577::aid-cncr2820570330>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
- Schlenker J. D., Bueno R. A., Ricketson G., Lynch J. B. Loss of silicone implants after subcutaneous mastectomy and reconstruction. Plast Reconstr Surg. 1978 Dec;62(6):853–861. doi: 10.1097/00006534-197812000-00004. [DOI] [PubMed] [Google Scholar]
- Vasconez L. O., Grotting J. C., Calderon W., Mathes S. J. Reconstruction of the breast: where do we fall short? An evolution of ideas. Am J Surg. 1984 Jul;148(1):103–110. doi: 10.1016/0002-9610(84)90296-4. [DOI] [PubMed] [Google Scholar]