What is a TRAM Flap?
A TRAM flap is a flap in which the blood supply is based upon the rectus abdominis muscle. Actually, the TRAM acronym stands for transverse rectus abdominis myocutaneous because the flap consists of muscle, skin and subcutaneous tissue harvested in a transverse orientation from the lower abdomen. In a TRAM flap, the breast is fashioned from the skin and subcutaneous fat of the lower abdomen, and the blood flow needed to nourish the flap accompanies the underlying rectus abdominis muscle. An ellipse of skin and fat is harvested from the abdominal wall (usually its lower part) and is rotated into the area of tissue loss created by the mastectomy. The flap remains attached to the body via the rectus muscle and is nourished by blood vessels that pass through the muscle. In most circumstances, the muscle opposite the mastectomy is chosen for use in the reconstruction, but the other side can be used. The muscle and soft tissue are tunneled under a skin bridge in the lower chest and are then
A Transverse Rectus Abdominus Myocutaneous (TRAM) flap involves using skin and fat from the lower abdomen to rebuild the breast. The muscle is used to carry blood supply to skin and fatty tissue so volume can be replaced to match what is removed. The abdominal closure tightens the abdominal wall similar to a tummy tuck.
TRAM is a natural breast reconstruction technique which uses skin, connective tissue, vascular tissue and muscular tissue from the patients lower abdominal region to recreate a breast after mastectomy or severe breast injury. The flap tissue is harvested from the area between the belly button and the pubic region. The common name for this technique is the tummy tuck breast reconstruction since the procedure is very similar to that used during an abdominoplasty operation. The flap is usually cut free from the lower abdomen and moved to the reconstruction site through the interior of the body, maintaining neurological and vascular supply to the tissue. Occasionally, a free tissue graft is harvested completely off the abdomen and then reattached on the chest wall, utilizing micro surgery to repair the nerve and blood vessel connections. This more complicated procedure is called a Free Flap TRAM Reconstruction. Other variations of the free TRAM procedure include the DIEP (deep inferior epi
