Transverse rectus abdominis myocutaneous flap wound-healing complications in breast reconstruction: assisted closure using foam suction dressing.

Transverse rectus abdominis myocutaneous (TRAM) flap necrosis is a difficult reconstructive problem which historically has entailed protracted management with poor aesthetic outcome. The use of a foam suction dressing achieves effective delayed primary closure of the flap wound with an acceptable aesthetic result. The results of using a vacuum-assisted closure (VAC) system were examined in three patients. The VAC system was found to be safe and effective in facilitating the closure of large and complex wounds without skin grafting. This option should thus be given serious consideration in some difficult wound healing situations.