Autologous Breast Reconstruction With Diep Or Pedicled Tram Abdominal Flaps

Publication Date: November 1, 2017
Last Updated: March 14, 2022

Recommendations

The Work Group suggests that clinicians may treat patients undergoing mastectomy and autologous breast reconstruction with either surgical technique (pedicled TRAM flap or DIEP flap, contingent on the use of mesh for pedicled TRAM procedures) because the risk of donor-site complications is comparable among procedures. Patient preference should have a substantial influencing role. (C)
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The Work Group suggests that clinicians may treat patients undergoing mastectomy and autologous breast reconstruction with either surgical technique (pedicled TRAM flap or DIEP flap) because the risk of flap-related complications is comparable among procedures. Patient preference should have a substantial influencing role. (C)
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Based on little or no systematic empirical evidence, it is the consensus of the Work Group that clinicians may treat patients undergoing mastectomy and autologous breast reconstruction with either surgical technique (pedicled TRAM flap or DIEP flap) since the risk of systemic complications (DVT and PE) is indeterminate among procedures. (D)
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Based on little or no systematic empirical evidence, it is the consensus of the Work Group that clinicians may treat patients undergoing mastectomy and autologous breast reconstruction with either surgical technique (pedicled TRAM flap or DIEP flap) because the risk of revision/reoperation and reconstruction failure is indeterminate among procedures. (D)
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Based on little or no systematic empirical evidence, it is the consensus of the Work Group that clinicians may treat patients undergoing mastectomy and autologous breast reconstruction with either surgical technique (pedicled TRAM flap or DIEP flap) because there were no differences in patient satisfaction noted. However, it was found that the level of patient satisfaction is high for both procedures. (D)
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Recommendation Grading

Overview

Title

Autologous Breast Reconstruction With Diep Or Pedicled Tram Abdominal Flaps

Authoring Organization

American Society of Plastic Surgeons

Publication Month/Year

November 1, 2017

Last Updated Month/Year

August 3, 2023

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

To develop recommendations for autologous breast reconstruction with abdominal flaps

Target Patient Population

Patients undergoing breast reconstruction with autologous abdominal flap

Inclusion Criteria

Female, Adolescent, Adult, Older adult

Health Care Settings

Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management, Treatment

Diseases/Conditions (MeSH)

D013518 - Surgery, Plastic, D001943 - Breast Neoplasms, D019651 - Reconstructive Surgical Procedures

Keywords

breast cancer, cosmetic surgery, plastic surgery, reconstructive treatment, Breast Cancer

Source Citation

Plastic and Reconstructive Surgery. 140(5):651e–664e, NOVEMBER 2017

Methodology

Number of Source Documents
25
Literature Search Start Date
January 1, 2003
Literature Search End Date
June 1, 2014