Retalho do músculo reto abdominal transverso autonomizado em pacientes obesas e fumantes

Hamilton Aleardo Gonella; Decio Luis Portella

doi:10.5327/Z1984-4840201625392

Authors

Hamilton Aleardo Gonella PUC-SP
Decio Luis Portella PUC-SP

DOI:

https://doi.org/10.5327/Z1984-4840201625392

Keywords:

mammoplasty, rectus abdominis, surgical flaps, obesity, smoking

Abstract

Introduction: Post-Mastectomy Breast reconstruction became popular in the late 1970s and early 1980s. At these surgeries through Transverse Rectus Abdominus Myocutaneous flap (TRAM), mainly in obese and smoking patients, it was demonstrated areas of partial or total necrosis. Experimental studies contributed in many ways to minimize these complications to 16%. But the necrosis occurrence was still high in obese and smoking patients (75%). A few authors began to do embolization or ligature at inferior epigastric plexus. Objective: This study aim is to show a way to make surgical delay of TRAM flap and its results. Methods: Retrospective study from 13 patients, in which this technic was performed. They were analyzed through Student and Tukey methods, presenting its statistical significance Results: One single patient presented epidermolysis. Discussion: The flap delay creates several local exchanges that results, usually after 10 to 21 days, at the increase of local vascular structures. Conclusion: Surgical delay of the TRAM flap as a surgical tactic and its definitive reconstruction after 15 days has been effective.

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Author Biographies

Hamilton Aleardo Gonella, PUC-SP

Professor do Depto. de Cirurgia FCMS/PUC-SP

Decio Luis Portella, PUC-SP

Professor do Depto. de Cirurgia FCMS/PUC-SP

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