Satisfaction following Unilateral Breast Reconstruction: A Comparison of Pedicled TRAM and Free Abdominal Flaps.

Plast Reconstr Surg Glob Open

Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, N.Y.; and Division of Plastic and Reconstructive Surgery, University of British Columbia, Vancouver, British Columbia, Canada.

Published: August 2015

AI Article Synopsis

  • The study compared patient satisfaction between two types of breast reconstruction: unilateral pedicled TRAM flaps and free abdominal flaps.
  • The assessment used the BREAST-Q survey, focusing on satisfaction with breasts, outcomes, and physical well-being.
  • Results showed that, initially, patients with pedicled TRAM flaps had higher satisfaction scores, but this difference decreased over time, indicating long-term satisfaction might be similar for both reconstruction methods.

Article Abstract

Background: The purpose of this study was to compare patient satisfaction following unilateral pedicled transverse rectus abdominis myocutaneous (TRAM) and free abdominal flap reconstruction.

Methods: Patients who underwent unilateral breast reconstruction using pedicled TRAM or free abdominal flaps (muscle-sparing TRAM or deep inferior epigastric perforator flap) and completed the BREAST-Q were identified from 2 prospectively maintained databases. BREAST-Q scores were assessed and compared for Satisfaction with Breasts, Outcome, and Physical Well-being Chest/Abdomen.

Results: Of the 138 patients who completed the BREAST-Q, 84 underwent pedicled TRAM flap reconstruction and 54 underwent free abdominal flap reconstruction. Overall, pedicled TRAM flap patients scored higher than free abdominal flap patients on all 4 BREAST-Q scales. This difference reached statistical significance in Satisfaction with Breasts (+7.74; P = 0.02). Similar results were found among patients who completed the BREAST-Q at <3 years postoperation. However, among patients at ≥3 years postoperation, there were no statistically significant differences between the 2 groups, with the pedicled flap cohort scoring higher in Satisfaction with Breasts and Physical Well-being Chest and the free abdominal flap cohort scoring higher in Satisfaction with Outcome and Physical Well-being Abdomen scores.

Conclusions: Patients who underwent unilateral pedicled TRAM flap reconstruction experienced greater initial breast satisfaction than patients who underwent unilateral free abdominal flap reconstruction, but satisfaction equalized between the two over time, suggesting that long-term satisfaction may be equivalent between the 2 methods of reconstruction.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560215PMC
http://dx.doi.org/10.1097/GOX.0000000000000458DOI Listing

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