Werdin Frank, Haug Daniel M, Amr Amro, Schoeller Thomas
Department of Plastic Surgery, Microsurgery and Reconstructive Breastsurgery, Marienhospital Stuttgart, Germany.
Microsurgery. 2016 Oct;36(7):539-545. doi: 10.1002/micr.22397. Epub 2015 Jun 9.
In cases were the deep inferior epigastric perforator flap (DIEP flap) is not available and unilateral transverse myocutaneous gracilis flap (TMG flap) is not sufficient for breast reconstruction, we perform double TMG flaps as a reconstructive method. In this report, we present our results of the use of double TMG free-flap-transfer for unilateral breast reconstruction.
Between August 2004 and June 2012 we performed 58 TMG flaps in 29 patients for unilateral breast reconstruction. Patient data were analyzed and operative outcome (operation time, complication rate and aesthetic results) were investigated. Aesthetic outcome was evaluated retrospectively via photo documentation by an independent plastic surgeon. The results were classified in;unsatisfactory, satisfactory, good and very good.
The average operating time was 6 hours 55 minutes (295 - 650 minutes). Of 58 TMG flaps, 57 (98.3%) were successful. Thrombosis occurred in seven (12%) cases (1 arterial, 6 venous). Flap salvage was successful in six cases and flap failure occurred in one (1.7%) case. The results of 25 patients were graded as good and very good. Three patients showed satisfying and one patient unsatisfying results.
Double TMG flaps in unilateral breast reconstruction could lead to good operative results. This method further expands the range of options with autologous tissue in reconstructive breast surgery. © 2015 Wiley Periodicals, Inc. Microsurgery 36:539-545, 2016.
在无法采用腹壁下深动脉穿支皮瓣（DIEP皮瓣）且单侧股薄肌肌皮瓣（TMG皮瓣）不足以进行乳房重建的情况下，我们采用双侧TMG皮瓣作为一种重建方法。在本报告中，我们展示了使用双侧TMG游离皮瓣移植进行单侧乳房重建的结果。
2004年8月至2012年6月期间，我们对29例患者进行了58例TMG皮瓣移植以进行单侧乳房重建。分析患者数据并调查手术结果（手术时间、并发症发生率和美学效果）。由一名独立的整形外科医生通过照片记录对美学效果进行回顾性评估。结果分为不满意、满意、良好和非常好。
平均手术时间为6小时55分钟（295 - 650分钟）。58例TMG皮瓣中，57例（98.3%）成功。7例（12%）发生血栓形成（1例动脉血栓，6例静脉血栓）。6例皮瓣挽救成功，1例（1.7%）皮瓣失败。25例患者的结果评为良好和非常好。3例患者结果为满意，1例患者结果为不满意。
双侧TMG皮瓣用于单侧乳房重建可取得良好的手术效果。该方法进一步扩大了自体组织在乳房重建手术中的选择范围。© 2015威利期刊公司。显微外科学36:539 - 545，2016。
