Wagner D S, Michelow B J, Hartrampf C R
Division of Plastic Surgery, Akron City Hospital, Ohio.
Plast Reconstr Surg. 1991 Dec;88(6):987-97. doi: 10.1097/00006534-199112000-00007.
Autogenous breast reconstruction with the pedicled TRAM flap has been employed in 500 patients in our series. We have developed and refined indications for use of the single-pedicle TRAM flap and double-pedicle TRAM flap in unilateral breast reconstruction. In our experience with 341 unilateral breast reconstructions, we used a double-pedicle TRAM flap 19 percent of the time; however, in our most recent 50 unilateral modified radical mastectomy reconstructions, the double-pedicle technique has been employed 60 percent of the time. In general, when a TRAM flap is chosen for unilateral reconstruction of a modified radical mastectomy defect, we feel the single-pedicle TRAM flap is the procedure of choice. Carefully selected patients will benefit from the added safety of a double-pedicle TRAM procedure. The indications for the double-pedicle TRAM flap, the technique, and our results are described in detail.
在我们的系列研究中，500例患者采用了带蒂横行腹直肌肌皮瓣（TRAM瓣）进行自体乳房重建。我们已经制定并完善了在单侧乳房重建中使用单蒂TRAM瓣和双蒂TRAM瓣的适应症。根据我们对341例单侧乳房重建的经验，我们使用双蒂TRAM瓣的比例为19%；然而，在我们最近的50例单侧改良根治性乳房切除术后重建中，双蒂技术的使用比例为60%。一般来说，当选择TRAM瓣用于改良根治性乳房切除术后缺损的单侧重建时，我们认为单蒂TRAM瓣是首选方法。经过精心挑选的患者将从双蒂TRAM手术增加的安全性中获益。本文将详细描述双蒂TRAM瓣的适应症、技术及我们的结果。
