BREAST RECONSTRUCTION FREE FLAPS

Course overview

THE INVENTION OF SILICONE IMPLANTS IN THE 1960S STARTED THE AGE OF PROSTHETIC BREAST RECONSTRUCTION. FREE FLAPS WERE NOT USED UNTIL THE LATE 1970S WHEN HOLMSTROM PUBLISHED USING A “FREE ABDOMINOPLASTY FLAP” FOR BREAST RECONSTRUCTION. HOWEVER, MICROSURGERY WAS NOT COMMONPLACE DURING THAT TIME. AUTOLOGOUS RECONSTRUCTION REALLY TOOK OFF WHEN DR. HARTRAMPF PUBLISHED HIS METHOD FOR PEDICLED TRAM (TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS) FLAP IN 1982. THE PEDICLED TRAM EVOLVED TO THE FREE TRAM, AS MICROSURGERY WAS MORE COMMON AND THE DEEP INFERIOR EPIGASTRIC ARTERY HAD IMPROVED BLOOD SUPPLY WHEN COMPARED TO THE SUPERIOR EPIGASTRIC ARTERY (THE BASIS OF THE PEDICLED FLAP). THIS PROCESS HAS FURTHER EVOLVED INTO THE FREE MS-TRAM (MUSCLE SPARING TRAM) AND DEEP INFERIOR EPIGASTRIC PERFORATOR (DIEP) FLAP, IN ADDITION TO UTILIZING OTHER FREE FLAPS FOR BREAST RECONSTRUCTION. THIS ACTIVITY DESCRIBES THE DIFFERENT TYPES OF FLAPS USED TO RECONSTRUCT THE BREAST, THEIR INDICATIONS, CONTRAINDICATIONS, AND COMPLICATIONS.