Closure of fascia after transverse rectus abdominis myocutaneous (TRAM) flap has usually been performed with direct closure or synthetic material. The dermal autograft removed from zone IV of the flap is an alternative to reinforce fascial closure. Record of the patients who had been undergone breast and head and neck reconstruction by TRAM flap between 1998-2008 were retrieved. In 34 cases dermal autograft and in 42 cases a synthetic mesh was used for closure of the abdominal fascial defect. All patients were followed by physical examinations for a mean period of 24 months. There were one (2.9%) bulging of the anterior abdominal wall and one (2.9%) wound infection in dermal autograft group and one (2.3%) true hernia in mesh repair group. Dermal autograft is a useful alternative to mesh repair of fascial defects after TRAM flap harvest.
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