Abstract
The DIEP and ms-TRAM flaps are standard flaps in autologous tissue reconstruction. The first TRAM flaps, transverse rectus abdominis muscle flap, were transposed cranially pedicled into the breast with a transverse skin island at the rectus abdominis muscle. The blood supply comes from the superior epigastric artery in flap. The disadvantage is that the transverse hypogastric islet is actually supplied dominantly from the inferior epigastric artery, and the anastomoses between the superior and inferior epigastric arteries are not always sufficient to supply the hypogastrium completely. The removal of the entire muscle and fascia sometimes resulted in abdominal wall problems, such as abdominal wall weakness or even herniation, consecutive mesh insertions, or pain.
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Bibliography
Section 12.1
Chen L, Hartrampf CR Jr, Bennett GK (1993) Successful pregnancies following TRAM flap surgery. Plast Reconstr Surg 91:69–71
Eom JS, Kim DY, Kim EK, Lee TJ (2016) The low DIEP flap: an enhancement to the abdominal donor site. Plast Reconstr Surg 137:7e–13e
Figus A, Wade RG, Gorton L, Rubino C, Griffiths MG, Ramakrishnan VV (2012) Venous perforators in DIEAP flaps: an observational anatomical study using duplex ultrasonography. J Plast Reconstr Aesthet Surg 65:1051–1059
Gravvanis A, Tsoutsos D, Papanikolaou G, Diab A, Lambropoulou P, Karakitsos D (2014) Refining perforator selection for deep inferior epigastric perforator flap: the impact of the dominant venous perforator. Microsurgery 34:169–176
Mohan AT, Zhu L, Wang Z, Vijayasekaran A, Saint-Cyr M (2016) Techniques and perforator selection in single, dominant DIEP flap breast reconstruction: algorithmic approach to maximize efficiency and safety. Plast Reconstr Surg 138:790–803
Moon HK, Taylor GI (1988) The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep superior epigastric system. Plast Reconstr Surg 82:815–832
Munhoz AM, Pellarin L, Montag E, Filassi JR, Tachibana A, Gebrim H, Gemperli R, Ferreira MC (2011) Superficial inferior epigastric artery (SIEA) free flap using perforator vessels as a recipient site: clinical implications in autologous breast reconstruction. Am J Surg 202:612–617
Pülzl P, Schoeller T, Wechselberger G (2006) Respecting the aesthetic unit in autologous breast reconstruction improves the outcome. Plast Reconstr Surg 117:1685–1691
Sarik JR, Bank J, Wu LC, Serletti JM (2016) Superficial inferior epigastric artery: learning curve versus reality. Plast Reconstr Surg 137:1e–6e
Section 12.2
Allen RJ, Haddock NT, Ahn CY, Sadeghi A (2012) Breast reconstruction with the profunda artery perforator flap. Plast Reconstr Surg 129:16e–23e
Arnez ZM, Pogorelec D, Planinsek F, Ahcan U (2004) Breast reconstruction by the free transverse gracilis (TUG) flap. Br J Plast Surg 57:20–26
Fansa H, Schirmer S, Warnecke IC, Cervelli A, Frerichs O (2008) The transverse myocutaneous gracilis muscle flap: a fast and reliable method for Breast reconstruction. Plast Reconstr Surg 122:1326–1333
Fansa H, Schirmer S, Cervelli A, Gehl HB (2013) Computed tomographic angiography imaging and clinical implications of internal mammary artery perforator vessels as recipient vessels in autologous breast reconstruction. Ann Plast Surg 71:533–537
Fattah A, Figus A, Mathur B, Ramakrishnan VV (2010) The transverse myocutaneous gracilis flap: technical refinements. J Plast Reconstr Aesthet Surg 63:305–313
Hunter JE, Lardi AM, Dower DR, Farhadi J (2015) Evolution from the TUG to PAP flap for Breast reconstruction: comparison and refinements of technique. J Plast Reconstr Aesthet Surg 68:960–965
Park JE, Alkureishi LW, Song DH (2015) TUGs into VUGs and friendly BUGs: transforming the gracilis territory into the best secondary breast reconstructive option. Plast Reconstr Surg 136:447–454
Schoeller T, Huemer GM, Wechselberger G (2008) The transverse musculocutaneous gracilis flap for Breast reconstruction: guidelines for flap and patient selection. Plast Reconstr Surg 122:29–38
Whitaker IS, Karavias M, Shayan R et al (2012) The gracilis myocutaneous free flap: a quantitative analysis of the fasciocutaneous blood supply and implications for autologous breast reconstruction. PLoS One 7(5):e36367. https://doi.org/10.1371/journal.pone.0036367
Yousif NJ, Matloub HS, Kolachalam R, Grunert BK, Sanger JR (1992) The transverse gracilis musculocutaneous flap. Ann Plast Surg 29:482–490
Section 12.3
Papp C, Windhofer C, Gruber S (2007) Breast reconstruction with the fasciocutaneous infragluteal free flap (FCI). Ann Plast Surg 58:131–136
Struckmann V, Peek A, Wingenbach O, Harhaus L, Kneser U, Holle G (2016) The free fasciocutaneous infragluteal (FCI) flap: Outcome and patient satisfaction after 142 Breast reconstructions. J Plast Reconstr Aesthet Surg 69:461–469
Section 12.4
Becker C (2016) Autologous lymph node transfers. J Reconstr Microsurg 32:28–33
Saaristo AM, Niemi TS, Viitanen TP, Tervala TV, Hartiala P, Suominen EA (2012) Microvascular breast reconstruction and lymph node transfer for postmastectomy lymphedema patients. Ann Surg 255:468–473
Bibliography on Other Flaps
Lateral Thigh Flap
Tuinder SMH, Beugels J, Lataster A, de Haan MW, Piatkowski A, Saint-Cyr M, van der Hulst RRWJ, Allen RJ (2017) The lateral thigh perforator (LTP) flap for autologous Breast reconstruction: a prospective analysis of 138 flaps. Plast Reconstr Surg. https://doi.org/10.1097/PRS.0000000000004072
SGAP and IGAP
Feller AM, Richter-Heine I, Rudolf KD (2002) The superior gluteal artery perforator flap (S-GAP-Flap). Handchir Mikrochir Plast Chir 34:257–261
LoTempio MM, Allen RJ (2010) Breast reconstruction with SGAP and IGAP flaps. Plast Reconstr Surg 126:393–401
Lumbar Flap
Hamdi M, Craggs B, Brussaard C, Seidenstueker K, Hendrickx B, Zeltzer A (2016) Lumbar artery perforator flap: an anatomical study using multidetector computed tomographic scan and surgical pearls for breast reconstruction. Plast Reconstr Surg 138:343–352
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Fansa, H. (2023). Free Flaps. In: Breast surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-65952-6_12
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DOI: https://doi.org/10.1007/978-3-662-65952-6_12
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