Ibrahim Galal Khalifa, M.D., Fathy
Khodair, M.D., and Tarek A. Said, M.D.
of Surgery, Faculty of Medicine, Cairo University.
Egypt. J. Plast. Reconstr. Surg.,
Vol 22, No 2, 1998: 141-151
The TRAM flap was used for breast reconstruction
in 30 cases. The blood supply of the flap was augmented by incorporation
of both superior epigastric pedicles in all cases. In addition retrograde
vascularization of the inferior epigastric vessels in the by microvascular
anastomosis to the subscapular vessels in the axilla was done in 8 cases
where large volume was needed. The ischemia rate of the augmented TRAM
was 3.3%, While other methods such as delay, free transfer, turbocharging,
unipedicled flap were accompanied by an ischemia rate of about 8.8-44%
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