What is included in preoperative care for a unipedicled TRAM breast reconstruction procedure?

Updated: Feb 14, 2019
  • Author: Michael R Zenn, MD, MBA, FACS; Chief Editor: James Neal Long, MD, FACS  more...
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Answer

The degree of preparation necessary for such a large procedure often is limited by the need to perform the mastectomy in a timely fashion. Preoperative instructions include the following:

  • Autogenous blood donation: Donate 2 units up to 2 weeks preoperatively (this is optional).

  • Abdominal conditioning: Patient should perform abdominal exercises to strengthen the muscle to be used and to improve blood supply to the muscle.

  • Perform bowel preparation the day before surgery.

For patients at higher risk (see Contraindications) or who require more tissue for the reconstruction, consider a delayed procedure or a free TRAM flap. If radiation is to be administered postoperatively, delay the reconstructive procedure at least 6 months to allow the chest tissues to heal completely to lower possible complications during elective reconstruction.


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