Original ArticleComplications Associated With Breast Reconstruction Using a Perforator Flap Compared With a Free TRAM FlapScheer, Adena S. BSc*; Novak, Christine B. PT, MSc‡; Neligan, Peter C. MB, FRCSC, FRCSI, FACS†; Lipa, Joan E. MD, MSc, FRCSC†Author Information From the *Faculty of Medicine and †Division of Plastic Surgery, University of Toronto, Toronto, Ontario, Canada; and the ‡Wharton Head & Neck Centre, University Health Network, Toronto, Ontario, Canada. Received September 25, 2005, and accepted for publication, after revision, December 1, 2005. Reprints: Peter C. Neligan, MB, Division of Plastic Surgery, Toronto General Hospital, 8N-865, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4. E-mail: [email protected]. Annals of Plastic Surgery: April 2006 - Volume 56 - Issue 4 - p 355-358 doi: 10.1097/01.sap.0000201549.83738.42 Buy Metrics AbstractIn Brief This study evaluated the recipient and donor site complications associated with breast reconstruction using a deep inferior epigastric artery perforator flap (DIEAP) flap compared with a free TRAM flap. The charts of 108 patients who underwent breast reconstruction using these techniques were reviewed. There were 130 flaps. Patients with free TRAM flaps had a significantly longer hospital stay (P = 0.003). There were significantly more cases of fat necrosis in the unilateral DIEAP flaps (P = 0.001). In patients who were overweight or obese (body mass index >25 kg/m2), there were significantly more breast complications (P = 0.006). There were more cases of abdominal flap necrosis at the donor site in smokers (P = 0.018) and the diabetic patients (P = 0.013). This study suggests that postoperative complications are related to patient comorbidities, and personal factors and should be considered when selecting the most appropriate reconstructive option. A comparison study of 130 unilateral and bilateral free TRAM flaps and DIEAP flaps for breast reconstruction showed longer hospital stays for TRAM flaps, greater fat necrosis in unilateral DIEAP flaps, and greater abdominal flap necrosis in smokers and diabetics. © 2006 Lippincott Williams & Wilkins, Inc.