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Free TRAM Flap Vs. Pedicled TRAM Flap
What is the difference between the free TRAM flap surgery and the pedicled TRAM flap surgery for breast reconstruction?
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The difference is how the blood flow is maintained to the flap
The free TRAM flap is separated from the body temporarily (hence "free") and its blood vessels are re-attached to blood vessels in the chest or armpit to keep it alive. The pedicled TRAM flap derives its blood flow from the upper part of the rectus muscle and is never separated from the body. It is tunneled into the chest where it is shaped into a breast.
The same tissue is transferred in each, but the free TRAM has a stronger blood flow and less functional sacrifice to the abdominal wall....
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Difference between a Free TRAM flap and Pedicled TRAM flap
A TRAM flap is a "Transverse Rectus Abdominus Muscle" flap that utilizes the abdominal muscle and fat to reconstruct the breast. Very simply, a pedicled TRAM flap uses the rectus muscle and abdominal flap to reconstruct the breast, via an intact and uncut artery in the upper abdomen.
A free TRAM flap is a traditional free flap wherein the same tissue is used, but unlike the pedicled TRAM, the artery is cut during the initial harvest and resewed in the chest to another artery....
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Los Angeles Plastic Surgeon
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Free TRAM versus Pedicled TRAM - the differences
Both of these techniques involve transfer of the lower abdominal wall tissue to the chest to reconstruct a breast either immediately at the time of mastectomy, or in a delayed fashion following mastectomy done in the past. Both operations rely on the fact that the tissue being transferred maintains a blood supply, and therefore can stay alive in its new position.
In a pedicled TRAM flap, the blood supply comes from a connection between the transferred skin and fat and the underlying rectus...
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Free and Pedicled TRAM flaps
A Free TRAM flap means that the blood supply is separated from its original location (the donor site) and lifted clear or "free" of the body and transplanted to the recipient site. The entire blood supply typically depends on 1 artery and 1 vein. If anything happens to these the blood supply could be compromised and the flap will die in it's entirety unless the problem is recognized immediately and surgically corrected.
A pedicled TRAM flap remains attached by a pedicle and is...
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Free TRAM vs. Pedicled TRAM
A pedicled TRAM flap is developed from the lower abdomen. It recruits the skin, subcutaneous fat and usually one rectus muscle and rotates it into the chest to recronstruct the breast. This is a pedicled or attached muscle along with its superiorly based blood supply. You have to detach its main inferiorly based blood supply to move this mound of tissue.
Because it detaches the main blood supply, you can not take all the tissue from the lower abdomen safely. This can be accomplished...
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DIEP Flap
The lower abdomen is a common source of tissue used to reconstruct the breast. The pedicled TRAM (Transverse Rectus Abdominus Flap) uses the skin and fatty tissue of the lower tummy by tunneling the tissue into the position of the breast. In this technique, the muscle of the abdomen (rectus abdominus muscle) is transferred, and the tissue remains attached to the body. The "Free TRAM" represented a technical advancement in that the tissue of the lower abdomen is...
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Abdominal Flaps for Breast Reconstruction- How Do They Differ from One Another
Musculocutaneous flaps such as the TRAM and free-TRAM incorporate muscle in their design. Muscle removed from the donor site serves as a conduit through which the blood vessels that nourish the soft tissue of the reconstruction travel. The sacrifice of muscle and fascia - the strong outer covering layer of muscle - from the donor site of any of flap is permanent. Muscle does not grow back. Removal of important functional muscle can lead to:
Weakness that may be...
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Free or pedicle TRAM which one is better?
As a plastic surgeon who has performed hundreds and hundreds of pedicle TRAM flap procedures since it's inception, I must say that it is a very safe procedure. This operation has a lower risk of complication and can be performed in any community hospital. The most critical part of the abdominal wall (the lower part) is affected the same way in both free and pedicle procedures. In unilateral procedures the weakness of the abdominal wall has been minimal. Even in bilateral cases, with...
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Free TRAM vs Pedicle TRAM
The differences between the free TRAM and the pedicle TRAM are severalfold:
1) Free TRAM uses less muscle from the abdomen.
2) Free TRAM has a better blood supply. The deep inferior epigastric artery is a more dominant blood supply to the abdominal region used in a TRAM flap then the superior epigastric vessles used in a pedicle TRAM. This generally results in less fat necrosis in a free TRAM flap. This really comes into significance for patients who are...
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TRAM Flaps 101
The best way to think of TRAM flaps is as follows:
A pedicled TRAM stays attatched to your body via muscle, so that the muscle has to be raised up and elevated in order to allow the TRAM flap to live. Their is more damage to the abdominal muscle area, but the surgery is shorter and lower risk of breast complications
A free TRAM means the flap is completely detatched from the body with a much smaller segment of muscle, then resewn into a blood vessel in your chest or armpit area. The...
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Plain English
The other posters seem to have very good explanations but as a surgeon that offers both free and pedicled, the main difference to the patient is:
1. Free: Requires sacrificing less of the belly muscle thereby leaving you with a stronger abdominal wall, according to some studies. The operation takes longer to do and has some specific technical demands (microsurgery)
2. Pedicled: Older operation, works just fine, but requires a sacrificing more of the abdominal muscle. Operation is quicker...
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Washington DC Plastic Surgeon
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Free versus Pedicled TRAM Flap
In breast reconstruction, a TRAM flap uses the skin and fat from the abdomen to reconstruct the breast. The difference between a "free" and a "pedicled" TRAM is based on the blood supply to this skin and fat.
Blood is supplied from arteries which course through the six-pack muscles of the abdomen, known as the rectus abdominus muscles. This blood supply then leaves the muscles and enters into the fat and skin. There are 2 main arteries, one coming from above (superior...
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Boca Raton Plastic Surgeon
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Difference between pedicled TRAM and free flap
In a pedicled TRAM flap the blood supply to the tissue used to reconstruct the breast is maintained through the rectus muscle. So the rectus muscle is used in the operation. As a result, patients cannot do sit-ups but otherwise are fine. It is very predictable and many surgeons are skilled in this procedure.
A free TRAM uses the same tissue but the blood supply is different. A blood vessel that supplies the tissue is divided and then it is reattached to another blood vessel; this is done...
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Connected versus free TRAM flap
Pedicle TRAM flaps involve the transfer of the whole rectus muscle and the overlying skin in the lower abdomen to the breast area. The blood supply is derived from the vessels within the muscle.The free tram uses a smaller area of the muscle and the vessels are connected to the arm pit or the chest wall vessels for survival.
