What is included in postoperative care following 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

See the list below:

  • An uncomplicated TRAM flap requires 4-5 days of hospitalization.

  • Ambulation begins on the first postoperative day.

  • To remove tension on the abdominal closure, place the patient in a flexed position at the waist for the first few days; an upright position is possible by the end of the first week.

  • Drain tubes are necessary and are usually in place for 1-2 weeks.

  • Patients require 6 weeks to 2 months to regain their energy level and resume normal activities.

  • Begin full range-of-motion exercises for the shoulder at 10-14 days postoperatively.

  • Patients may resume abdominal exercises in 8 weeks.

  • Anesthesia of the mastectomy site and central abdomen resolves over the next 6-12 months. The degree of sensory reinnervation to the TRAM flap is variable and patient-dependent. [9]

  • Because of the tight closure of the underlying muscle fascia of the abdomen, most patients experience a painless tight feeling for many months.

  • Patients with preexisting back pain may have an exacerbation of this pain from the procedure and may want to consider an alternative method of reconstruction (eg, implant reconstruction).

  • Prolonged convalescence and discomfort coupled with a cancer diagnosis may be depressing and emotionally draining.


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