Importance of right subcostal incisions in patients undergoing TRAM flap breast reconstruction.

摘要: The presence of a preexisting subcostal incision alters the approach to breast reconstruction and is thought predispose donor site skin complications flap loss. purpose this study was determine whether scar affects or morbidity adversely after transverse rectus abdominis musculocutaneous (TRAM) reconstruction. Twenty-six patients with right (group A) underwent TRAM (13 immediate, 13 delayed). average age 51 years, had an body mass index 25.3. There were 15 right, 10 left, 1 bilateral (4 free flaps, 22 pedicled). Outcome measures compared 126 age- risk-matched B) who without any abdominal scar. in group B 46.7 24.8. length stay A 5.9 days, 4.8 days ( < 0.05). no significant differences breast-related complications. Donor higher A, wall necrosis being significantly (25%) those scars (5%; = 0.02). Multivariate analysis revealed 6.5-fold increase smoking history When adjusted for radiation treatment, increased incidence complication rate only marginally 0.08). effective certain technical modifications; however, there slight predisposition Smoking influenced outcome further incision, stressing importance proper patient selection.