Experience with free TRAM breast reconstruction at an American Army Medical Center.

There are many civilian reports on the outcomes of the free transverse rectus abdominis muscle (TRAM) flap for breast reconstruction. There are no published reports by U.S. military surgeons with this technique. The records of patients undergoing this operation from November 2002 to December 2004 at an Army Medical Center were reviewed. Twenty-one women underwent 27 free TRAM flaps during the study period. No flaps were lost. Significant complications were encountered in 47.6% (10/21) of patients. Seven of these 10 patients had surgery for donor site scar revision. Although technically demanding and time consuming, free TRAM breast reconstruction provides an esthetic result. Free tissue breast reconstruction can be successfully performed with minimal morbidity at U.S. Army Hospitals.