A systematic approach to the tram flap breast reconstruction

Abstract Although the use of the transverse rectus abdominis musculocutaneous (TRAM) flap is well established as a means of breast reconstruction, the technical refinements that are necessary to achieve optimal results are all too often overlooked. Systematization of breast reconstruction when performed using the TRAM flap is therefore suggested. A detailed planning of the reconstruction from preparation of the donor and recipient sites to the distribution of the flap is discussed. Use of this approach in 16 patients undergoing breast reconstruction using the TRAM flap procedure showed an improvement in symmetry and shape of the new breast and a decrease in the operating time versus other TRAM flap procedures in which the flap is positioned without a systematic approach.