| dc.description.abstract | Objective: Abdominal based free flaps such as the Transverse Rectus Abdominis
Myocutaneous (TRAM) flap and Deep Inferior Epigastric Perforator
(DIEP) flap are essential tools in the reconstructive armamentarium post
mastectomy. These reconstructions are often prolonged, complex and associated
with complications. This study aims to compare the complication rate,
particularly focusing on perioperative transfusions, between TRAM and DIEP
flaps performed by the senior author in our tertiary referral centre. Methods:
A retrospective review was conducted of one hundred and seven consecutive
TRAM and DIEP flaps from 2000 to 2014. The two groups were analysed for
demographics, preoperative risk factors and post-operative complications including
blood transfusions, haematomas, flap losses, redo-anastomoses, flap
infections, abdominal wound sequelae and non-surgical complications. Results:
Sixty-three patients underwent 67 free/muscle sparing TRAM flaps and
35 patients underwent 40 DIEP flaps. There were no statistically significant
differences in patient demographics or preoperative risk factors between the
two groups. Five TRAM flap cases (7.9%) required transfusion whilst no DIEP
flap cases required transfusion. This difference was not found to be statistically
significant (p = 0.16). However, free/muscle-sparing TRAM flaps were
found to have a significantly higher overall complication rate compared to
DIEP flaps (23.8% vs. 5.7%, p = 0.02). Conclusion: The current study demonstrated
no difference in perioperative transfusion requirement between
TRAM and DIEP cases. There was however a significantly higher rate of overall
complications associated with TRAM flaps warranting the authors to conclude
that care be taken when opting for this reconstructive method. | en_US |
