The TRAM flap in breast reconstruction.

With the TRAM flap, the surgeon can restore the woman's breast using her own tissue while simultaneously giving her a flatter abdomen (Noguchi et al., 1992). Monitoring of the flap begins in the recovery room. Nurses monitor the flap by assessing the Doppler signal, color, temperature, and capillary refill every 15 minutes. Before the patient goes home, she is instructed in wound and drain care, and the nurses outline encouraged activities and activity restrictions.