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Wurzer, P; Spendel, S; Kamolz, LP; Parvizi, D; Tuca, A; Rappl, T.
Is there a psychological and physiological difference between DIEP- and free TRAM-flap? A retrospective patient survey].
Handchir Mikrochir Plast Chir. 2014; 46(4):256-262 Doi: 10.1055/s-0034-1384578
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Führende Autor*innen der Med Uni Graz
Wurzer Paul
Co-Autor*innen der Med Uni Graz
Kamolz Lars-Peter
Parvizi Daryousch
Rappl Thomas
Spendel Stephan
Tuca Alexandru

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The DIEP- (Deep Inferior Epigastric Perforator) flap and the free TRAM- (Transverser Rectus Abdominis Musculocutaneous) flap are common procedures for breast reconstruction. The aim of the study was to identify a difference in the psychological and physiological patient satisfaction between DIEP- and free TRAM-flap. To provide a homogenous group, with a stable result of the reconstruction, the collective for questioning was picked out of the years 2009 and 2010. All patients included underwent a breast reconstruction with a DIEP-flap or free TRAM-flap at our division. For evaluation we formed 2 groups: DIEP-flap group (DLG) and TRAM-flap group (TLG). After preparing the questionnaire a telephone survey was performed. For the null hypothesis we postulated that there is no difference between DLG and TLG in the patient satisfaction. We contacted 44 patients, 30 of them took part in our survey (15 from the DLG and 15 from the TLG). The mean BMI in the questionnaire group was 26.9 kg/m² and the mean age was 48.3 years. 2 questions (lifting heavy loads (p=0.005) and performing sit-up's (p=0.001)) show a significant difference between DLG and TLG, a benefit of the DLG could be seen. Both questions had the physiology of the rectus abdominis muscle as background. The complication rate for partial flap loss or partial necrosis was one third lower (p=0.299) in the TLG than compared to the DLG. Up to now, physicians think that the DIEP-flap seems to be the best possible procedure for breast reconstruction with belly flaps. However, numerous studies disprove the superiority in the donor site morbidity. In the literature, an advantage of the TRAM-flap is clearly visible by comparing the complication rates. Our oral interviewing also states that there is no -difference in the psychological and physiological satisfaction of the patients. We can recommend a precise patient selection if a DIEP-flap for breast reconstruction should be performed. In case of comorbidities the possibility of the safer free TRAM-flap should be considered. In the future, a comparative analysis between the DIEP-flap, free TRAM-flap and pedicled TRAM-flap should be performed, by keeping the patients satisfaction, the complication rate and the cost effectiveness in mind. © Georg Thieme Verlag KG Stuttgart · New York.
Find related publications in this database (using NLM MeSH Indexing)
Activities of Daily Living - psychology
Adult -
Breast Neoplasms - psychology Breast Neoplasms - surgery
Epigastric Arteries - surgery
Female -
Graft Survival - physiology
Humans -
Interviews as Topic -
Mammaplasty - methods Mammaplasty - psychology
Microsurgery - methods Microsurgery - psychology
Middle Aged -
Myocutaneous Flap - surgery
Patient Satisfaction -
Perforator Flap - surgery
Postoperative Complications - etiology
Surgical Flaps - surgery
Surveys and Questionnaires -

Find related publications in this database (Keywords)
breast reconstruction
free flap plasty
breast cancer
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