AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...

A Comparison of Donor Site Morbidity of the SIEA, DIEP, and ms-TRAM Flaps for Breast Reconstruction
Institution where the work was prepared: MD Anderson Cancer Center, Houston, TX, USA
Liza C. Wu, MD; Anureet Bajaj; David W. Chang, MD; Pierre Chevray, MD, PhD; University of Texas, MD Anderson Cancer Center
Purpose:
Lower abdominal tissue remains the gold standard for autologous tissue breast reconstruction. The TRAM flap harvest technique has evolved to reduce donor
site morbidity. This is a comparative study of the donor site function and outcomes of patients who have undergone SIEA flap, DIEP flap, or free ms-TRAM
flap breast reconstruction. We investigate the postoperative morbidity and complications and examine patient perceptions of abdominal donor site aesthetics,
pain, and function.
Methods:
A 12-item questionnaire was sent to elicit patient perceptions regarding donor site aesthetics, pain, and function. A retrospective chart review was used to
obtain demographic data and outcomes with regard to donor site complications.
Results:
179 patients during a 5-year period were included in the study. There were 126 unilateral breast reconstruction patients (23 SIEA, 24 DIEP, 79 ms-TRAM), and
53 bilateral reconstruction patients (6 SIEA/SIEA, 5 SIEA/DIEP, 7 SIEA/ms-TRAM, 8 DIEP/DIEP, 4 DIEP/ms-TRAM, 23 ms-TRAM/ms-TRAM). The survey response
rate was 63%. There was no difference between responders and non-responders with regard to follow-up, BMI, timing of surgery, flap type, smoking history,
or comorbidity. For the patients with a unilateral breast reconstruction, there was no perceived difference between the SIEA vs. DIEP flap patients with regard
to abdominal contour, postoperative pain, or abdominal function. There was no difference between the SIEA vs. ms-TRAM flap patients with regard to abdominal
contour. There was a trend toward SIEA patients having less postoperative pain than ms-TRAM patients. There was a statistically significant difference
(p