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IPSI vs CONTRA TRAMa??Old Doubts New Answers: Evaluation TRAM Flap Survival with Static and Active Dynamic Thermography in Pedicled Flap Breast Reconstruction

DOI:10.1007/s12262-020-02130-0 期刊:Indian Journal of Surgery 出版年份:2020 更新时间:2025-09-23 15:21:01
摘要: Breast reconstruction is increasingly being considered as the next step in breast cancer treatment. There are many ways to recreate a new breast mound. In current times, the trend for breast reconstruction is reconstruction microsurgery which is the method of choice, but newcomers should know the alternative traditional methods. Since 1982 the pedicled TRAM (trans rectus abdominal myocutaneous) flap has become one of the most popular autologous tissue breast reconstruction procedures. It has also been debated for many years which method of transferring the tissue island is more reliable and has fewer complications—IPSI vs CONTRA [1]. The reasons for complications are the manner of twisting the nourishing blood supply and the tension due to the distance of the pedicle in both procedures [2]. Static thermography and dynamic thermography seem to provide the solution. In our experiment, we measured the medial surface temperature of flaps using static thermography and active dynamic thermography. The results were compared against the number of flap failures in each type of reconstruction. The study was conducted on a group of 20 female patients who underwent breast reconstruction.
作者: Jerzy Jankau,Szymon Kolacz,Mateusz Moderhak
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To compare the clinical examination of TRAM flap and the images generated in intraoperative static thermography and cold-stress active dynamic thermography (ADT) both prior to and after twisting the vascular pedicle of the flap, and in subsequent postoperative days in the reconstructive procedures with TRAM IPSI-lateral and CONTRA-lateral flaps.

IPSI-lateral TRAM flaps have better blood supply than CONTRA-lateral TRAM flaps. However, it should be noted that each surgeon should take his or her own experience and expertise into consideration while selecting the method which is appropriate for a particular patient and can offer the best aesthetic effect.

The study was conducted on a relatively small group of 20 patients, which may limit the generalizability of the findings. Additionally, the results of the preoperative (b1) exam and intraoperative exam performed following the dissection and resection of excess flap (b2), and the exam performed after 30 and 90 days (b6 and b7) were not included in this study because of the lack of relevance.

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