Abstract
Abstract The transverse rectus abdominis myocutaneous (TRAM) flap retains a prominent role in contemporary breast reconstruction surgery. This chapter reviews the origins and anatomy of the TRAM flap, both as a pedicled and free tissue transfer. Patient selection and flap planning are examined in the context of immediate and secondary breast reconstruction with attention to oncological considerations and patient risk factors. The elements influencing choice between a pedicled or free flap are discussed and some guidelines to decision-making for abdominal based breast reconstruction are offered. Detailed descriptions of surgical technique and perioperative care follow, illustrated by case examples.
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