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2 Medical Resident - Medical Resident of the Second Year of Plastic Surgery of the CHMFRP-USP. 3 ABSTRACT Introduction: The repair of the abdominal wall after breast reconstruction with a transverse rectus myocutaneous (TRAM) flap is a challenge for the surgeon, and there is still no consensus in the literature about which is the best technique. The objective of this study is to evaluate the efficiency of the Ultrapro ® mesh in two different anatomical planes for the repair of the ab- dominal wall after TRAM flap surgery. Method: This is a retrospective study conducted through a medical records review of 24 patients who underwent breast reconstruction with a pedicle TRAM flap, and repair of abdominal donor site with a dual mesh of polypropylene and polyglecaprone - Ultrapro, at the Plastic Surgery Division of the Clinics Hospital of the Medicine Faculty of Ribeirao Preto - University of Sao Paulo. We evaluated the risk factors for abdominal hernias or bulges, time of breast reconstruction, postopera- tive complications (including abdominal hernias or bulges), and postopera- tive follow-up. Results: Of the 24 patients with a mean age of 51 years, 10 (41.6%) had a comorbidity. In 95.8% of the patients, breast reconstruction was late; the TRAM flap was a single pedicle in 58.4% of cases. The most frequent postoperative complications were suture dehiscence (25%) and se- roma (21%). Two patients (8.4%) were found to have abdominal hernia, and three patients (12.5%) had abdominal bulging. The postoperative follow-up ranged from 5 to 48 months (average, 23.4 months, SD = 13.28). Conclu- sion: The use of the Ultrapro hybrid mesh at two anatomical planes proved to be an alternative for the repair of the abdominal wall after TRAM flap surgery for breast reconstruction, with low morbidity of the abdominal donor site and complication rates similar to literature data.

Abdominal wall repair with double-mesh polypropylene/polyglecaprone after TRAM flap surgery for breast reconstruction