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*AN ULTRASONOGRAPHIC AND CLINICAL EVALUATION OF RECTUS MUSCLE FUNCTION – FOLLOWING DIEP AND MUSCLE‐SPARING TRAM BREAST RECONSTRUCTION
Author(s) -
Fullarton A. C.,
Ngan N. C.,
Armstrong J.,
Tan S. T.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04927_23.x
Subject(s) - medicine , rectus abdominis muscle , breast reconstruction , diep flap , abdominal wall , umbilicus (mollusc) , rectus muscle , abdominal muscles , anatomy , surgery , breast cancer , cancer
Background: An advantage of breast reconstruction with a deep inferior epigastric perforator (DIEP) flap compared with the standard or muscle‐sparing transverse rectus abdominis muscle (TRAM) flap is preservation of the entire rectus muscle. However this purported advantage has not been fully evaluated. Aim: This study evaluates rectus muscle morphologically and clinically following unilateral breast reconstruction with DIEP and muscle‐sparing TRAM flaps. Methods: The rectus muscle was examined ultrasonographically in 20 patients, at least 18 months after following breast reconstruction. Rectus muscle thickness was measured at three points along its length when relaxed and when contracted; the un‐operated side was used as a control. Results: Rectus muscle at or below the umbilicus was thinner after muscle‐sparing TRAM but was unchanged after DIEP reconstruction. However, its contractility (measured as a ratio of contracted and relaxed muscle thickness) was unchanged by either operation. Clinically, there is no difference in abdominal wall function between the two types of operation. Conclusion: The purported advantage of DIEP flap over muscle‐sparing TRAM breast reconstruction, with regard to abdominal wall integrity, requires further investigation.