TRAM rag
TRAM flap (Tram = Transverse Rectus Abdominis Musculocutaneus flap), also known as the transverse lower abdominal flap , is a muscle flap that is used in plastic surgery to reconstruct the breast . The body's own (autologous) tissue is removed to shape the breast. A reconstruction of the nipple is then usually necessary. The TRAM flap was first described by Holmstrom in 1979.
Action
Here, lower abdominal fat tissue is lifted together with the straight abdominal muscle ( rectus abdominis muscle ) and shifted as a pedunculated flap to the chest region, the vascular supply is not interrupted. Alternatively, the cloth can also be used as a free cloth. The inferior epigastric vessels are interrupted and microsurgical revascularization of the breast takes place. The free flap is also known as the muscle-sparing free tram flap, as this method only removes the muscle portion from the rectus abdominis muscle, where the epigastric vessels enter.
The vascular supply is ensured via the superior epigastric artery and inferior epigastric artery running in the rectus abdominis muscle . The inferior epigastric artery plays a decisive role in tissue transplantation, as it has a larger diameter and a longer vascular pedicle.
The operation of a pedicled TRAM flap takes about 4–5 hours, a free transfer usually takes longer.
Web links
Individual evidence
- ↑ Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction. Scand J Plast Reconstr Surg. 1979; 13: 423-427. [PubMed]