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Analysis of Complications and Patient Satisfaction in Pedicled Transverse Rectus Abdominis Myocutaneous and Deep Inferior Epigastric Perforator Flap Breast Reconstruction

Momoh, Adeyiza O. MD*; Colakoglu, Salih MD*; Westvik, Tormod S. MD*; Curtis, Michael S. MD; Yueh, Janet H. MD*; de Blacam, Catherine MB BCh*; Tobias, Adam M. MD*; Lee, Bernard T. MD*

doi: 10.1097/SAP.0b013e318221b578
Breast Surgery
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The purpose of this study was to evaluate complications and patient satisfaction after pedicled transverse rectus abdominis myocutaneous (TRAM) and deep inferior epigastric perforator (DIEP) flap reconstruction at a single institution. There were 346 patients identified from 1999 to 2006 who underwent 197 pedicled TRAM and 217 DIEP flap reconstructions. Flap complication rates were similar between groups, whereas pedicled TRAM reconstructions had higher rates of abdominal bulge (9.5% vs. 2.3%, P = 0.0071) and hernias (3.9% vs. 0%, P = 0.0052). DIEP flap patients had significantly higher general satisfaction (81.7% vs. 70.2%, P = 0.0395), whereas aesthetic satisfaction was similar between groups. Furthermore, DIEP flap patients, particularly those undergoing bilateral reconstructions, were more likely to choose the same type of reconstruction compared with pedicled TRAM patients (92.5% vs. 80.7%, P = 0.0113). Understanding the differences in complications and satisfaction will help physicians and patients make informed decisions about abdominal-based autologous breast reconstruction.

From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and†Division of Plastic and Reconstructive Surgery, State University of New York Upstate Medical University, Syracuse, NY.

Received April 5, 2011, and accepted for publication, after revision, April 27, 2011.

Conflicts of interest and sources of funding: Supported by the Peter Jay Sharp Foundation (to A.O.M., S.C., M.S.C., A.M.T., and B.T.L.).

Reprints: Bernard T. Lee, MD, FACS, Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Ste 5A, Boston, MA 02215. E-mail: blee3@bidmc.harvard.edu.

© 2012 Lippincott Williams & Wilkins, Inc.