Using pedicled TRAM flap in conjunction with the bony anchoring reinforcement system (BARS) for abdominal wall reconstruction

This study, also published in the European Journal of Plastic Surgery, focuses specifically on the use of BARS in conjunction with pedicled TRAM flap breast reconstruction.

Methodology and Patient Cohort

The study included 21 patients undergoing pedicled TRAM flap breast reconstruction with BARS reinforcement of the abdominal wall. The technique involves anchoring synthetic mesh to bony landmarks to provide additional support following flap harvest.

Key Findings

With a mean follow-up of 62 months, the results are promising:

1. No cases of abdominal wall hernias
2. One patient developed bulging, which was successfully retreated
3. Two patients had mesh infections, but none required complete mesh removal
4. No flap failures were reported

Implications for Clinical Practice

This combined approach offers several benefits:

• Provides robust abdominal wall reinforcement after TRAM flap harvest
• Demonstrates low complication rates
• Potentially reduces the risk of abdominal wall weakness and hernia formation

These initial results suggest that combining pedicled TRAM flaps with BARS could improve outcomes in breast reconstruction while minimizing abdominal wall morbidity.

We encourage you to read the full study for a detailed review of the technique and outcomes.