Purpose: Recently, there has been increasing concern regarding the potential for abdominal morbidity following breast reconstruction with pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. The purpose of the present study was to analyze a large, consecutive series of pedicled TRAMs performed by a single surgeon and examine the incidence of abdominal morbidity.

Methods: Between December 1998 and June 2005, 117 women underwent breast reconstruction with pedicled TRAMs by the senior author. All abdominal repairs were reinforced with polypropylene mesh. Reconstruction was unilateral in 105 women (90%) and bilateral in 12 women (10%). The charts were retrospectively reviewed for abdominal complications and associated demographics.

Results: The mean follow-up period was 23.3 months. In the 117 patients, there was 1 hernia (0.85%), 1 abdominal bulge (0.85 %), 2 superficial infections (1.7%), 1 partial skin loss (0.85%), 1 hematoma (0.85%), and 0 seromas. No patient developed a mesh infection, or complained of persistent abdominal weakness.

Conclusions: Although many authors have reported concern over potentially high rates of abdominal morbidity following pedicled TRAMs, abdominal complication rates in the current series were uniformly low. We therefore believe that pedicled TRAM flaps remain a good option for many women seeking breast reconstruction.