The “Perfusion Map” of the Unipedicled TRAM Flap to Reduce Postoperative Partial Necrosis

Abstract

The unipedicled transverse rectus abdominis musculocutaneous (TRAM) flap is a well-known technique for breast reconstruction. However, it is clinically difficult to evaluate the blood perfusion of the flap in the operating room. A new technique of blood supply evaluation, employing indocyanine green dye (ICG) fluorescence videoangiography has been performed in 10 cases of unipedicled TRAM flap breast reconstruction. In our series, the ICG measurement was demonstrated to be a safe, quick, and accurate technique of flap perfusion analysis. We confirmed the presence of individual pattern (“perfusion map”) of the flap perfusion, zone II sometimes not being as well perfused as zone III.

In this paper, we present our descriptive findings, and the ICG analysis seems to have a predictive value of unipedicled TRAM flap viability.

In Brief

Ten unipedicled TRAM flap breast reconstructions were evaluated intraoperatively with indocyanine green dye (ICG) fluorescence videoangiography, demonstrating accuracy of individual flap perfusion mapping with strong predictive value for final viability. Zone II was often not as well perfused as Zone III.