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Abdominal Wall Integrity Complications Following TRAM Breast Reconstruction
Michael DePerro III, MD
Douglas Wagner, MD
Lewis Diulus III, MD
Summa Health System
2015-03-15
Presenter: Michael DePerro III, MD
Affidavit:
The resident performed over 50% of the work for this abstract
Director Name: Douglas Wagner, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
OBJECTIVE:
To compare the rate of abdominal wall integrity complications following TRAM breast reconstruction looking specifically at the rate of abdominal wall bulges, abdominal wall hernia, and mesh infection that required surgical revision.
METHODS:
We performed a 10 year retrospective review of a single surgeon's outcomes following TRAM breast reconstruction. We reviewed 207 charts and looked at the rate of abdominal wall bulges, true hernia occurrence, mesh infection, and bulge/hernia recurrence after primary repair. We then looked specifically at how this correlated with the patient's age, BMI, rate of HTN and DM, and smoking history.
RESULTS:
16% of TRAM breast reconstruction patients developed an abdominal wall integrity complication that required surgical intervention. Intraoperative exploration showed that the majority of these patients had an abdominal wall bulge and not a true hernia. Recurrent abdominal wall bulge and/or hernia were rare. Risk factors for developing an abdominal wall integrity complication included having a bilateral procedure, increased age, an increased BMI, and smoking.
CONCLUSIONS:
TRAM breast reconstruction is associated with many more abdominal wall bulges than true abdominal wall hernias. The factors that are associated with the greatest chance of an abdominal wall integrity complication include a bilateral procedure, mesh infection, increasing age, and a recent history of smoking.
