What is the Difference Between a TRAM Flap and DIEP Flap?

What is the Difference Between a TRAM Flap and DIEP Flap?

The TRAM flap is the acronym of Transverse Rectus Abdominis Muscles flap. It is the most common type of flap includes the muscles, fat and skin taken from the lower abdomen in a breast surgery and moved in the chest area. It reduces the amount of fat and skin in the lower belly. TRAM flap can be used as pedicle or free flap. On the contrary, the Deep Inferior Epigastric Artery Perforator flap (DIEP) is a free flap which includes only the fat and skin from the lower abdomen leaving out the muscles.

The flap surgery can be done in any of the following ways:

Pedicle Flap: The surgery can be done using a pedicle flap, which means a flap of tissue from the buttock or the abdomen is taken and moved to the chest without cutting its original blood supply. Only the tissue is pulled under the skin up to the chest and attached.

Free Flap: At times, the flap technique of surgery is done using free flap, which include the blood vessels along with the tissue. They are cut and placed on the chest and then the surgeon sews the blood vessels of the flap to the blood vessels of the chest area. This is a more complicated process and requires using a microscope.

What are the Various Types of Breast Flaps Other Than TRAM Flap and DIEP Flap?

There are various types of flaps which may be used and it all depends on the place from which they are taken from. Few of the types of breast flaps involve-

Pedicle Flap Surgery: Muscles, fat and skin are taken from the upper back and moved to the chest area.

Gluteal Free Flap- As the name suggests, it can be used as a free flap. Fat, skin and muscles are taken from the buttocks to reconstruct the breast.

Transverse Upper Gracilis flap (TUG) – This is another form of free flap that can be used from the inner upper thigh for the new breast reconstruction. This may be advantageous because the scar so formed will be hidden inside the thigh and groin. This may be beneficial for women who have small breasts and do not have enough tummy muscles for the reconstruction.

Superficial Inferior Epigastric Artery flap (SIEA) – This form of flap is similar to DIEP flap. The only difference in this surgery is that it does not cut through the belly muscles to get to the artery in order to use it for the new breast construction.

What Are The Cons Of Having A Flap Surgery?

Every surgery has its own set of pros and cons. Some of the cons of flap surgery include-

Recovery Time: As compared to breast implantation procedure, the flap procedure requires more surgery and longer procedure for recovery.

Surgical Scars: Flap procedure of surgery leaves two surgical scars, one where the tissue was taken from and the other on the reconstruction site. Although the scars fade overtime, they never go away.

Poor Blood Circulation: Flap procedures may not be the best option for smokers and for patients who have uncontrolled diabetes and problems of poor blood circulation because healthy blood vessels are needed for the blood supply of the flap tissue.

How Long Does It Take to Recover from a DIEP Flap?

Generally in most circumstances the drains remain for a period of two weeks. In case the leakage is more, they have to stay longer. The recovery time for the DIEP flap surgery is around 4 to 6 weeks. The patient may be sore for a week and then begin to heal every day.

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