The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap

Background: Muscle sparing-transverse rectus abdominis flap has been widely used for breast reconstruction and the abdominal hernia or bulging at the donor site is relatively common complication. Previous studies have emphasized the fascial defects and the defect of muscle has been neglected. This...

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Main Authors: Yumin Kim, Ji-Young Kim, Hak Chang
Format: Article
Language:English
Published: Medical Journals Sweden 2025-03-01
Series:Journal of Plastic Surgery and Hand Surgery
Subjects:
Online Access:https://medicaljournalssweden.se/JPHS/article/view/42961
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author Yumin Kim
Ji-Young Kim
Hak Chang
author_facet Yumin Kim
Ji-Young Kim
Hak Chang
author_sort Yumin Kim
collection DOAJ
description Background: Muscle sparing-transverse rectus abdominis flap has been widely used for breast reconstruction and the abdominal hernia or bulging at the donor site is relatively common complication. Previous studies have emphasized the fascial defects and the defect of muscle has been neglected. This study aims to investigate the relationship between the size of the rectus abdominis muscle defect and its impact on hernia or bulge formation after muscle sparing-transverse rectus abdominis flap. Materials and methods: A retrospective study of patients undergoing unilateral or bilateral breast reconstruction with muscle sparing-transverse rectus abdominis myocutaneous flap was performed. We compared the patient group with postoperative abdominal hernia or bulging requiring surgery with the patient group without hernia. The surgical specific data of the size of rectus abdominis muscle defect, muscle sparing type and flap weight are analyzed.  Results: We conducted a survey on a total of 160 patients, of which six patients experienced abdominal hernia or bulging requiring surgery. Comparing patient group requiring surgical treatment for hernia or bulging with patient group without hernia, there was a significant difference of the width of rectus abdominis muscle defect. The cut-off value of the width was 4.5 cm.  Conclusion: When performing MS-TRAM, minimizing the resection of rectus abdominis muscle remains crucial, especially the horizontal width.
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spelling doaj-art-1759bdec091347ca8d3b51fc678a50cc2025-08-25T11:16:00ZengMedical Journals SwedenJournal of Plastic Surgery and Hand Surgery2000-67642025-03-0160110.2340/jphs.v60.42961The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flapYumin Kim0Ji-Young Kim1Hak Chang2Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Republic of KoreaDepartment of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Republic of KoreaDepartment of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Republic of Korea Background: Muscle sparing-transverse rectus abdominis flap has been widely used for breast reconstruction and the abdominal hernia or bulging at the donor site is relatively common complication. Previous studies have emphasized the fascial defects and the defect of muscle has been neglected. This study aims to investigate the relationship between the size of the rectus abdominis muscle defect and its impact on hernia or bulge formation after muscle sparing-transverse rectus abdominis flap. Materials and methods: A retrospective study of patients undergoing unilateral or bilateral breast reconstruction with muscle sparing-transverse rectus abdominis myocutaneous flap was performed. We compared the patient group with postoperative abdominal hernia or bulging requiring surgery with the patient group without hernia. The surgical specific data of the size of rectus abdominis muscle defect, muscle sparing type and flap weight are analyzed.  Results: We conducted a survey on a total of 160 patients, of which six patients experienced abdominal hernia or bulging requiring surgery. Comparing patient group requiring surgical treatment for hernia or bulging with patient group without hernia, there was a significant difference of the width of rectus abdominis muscle defect. The cut-off value of the width was 4.5 cm.  Conclusion: When performing MS-TRAM, minimizing the resection of rectus abdominis muscle remains crucial, especially the horizontal width. https://medicaljournalssweden.se/JPHS/article/view/42961Herniarectus abdominis muscletransverse rectus abdominis myocutaneous flap
spellingShingle Yumin Kim
Ji-Young Kim
Hak Chang
The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap
Journal of Plastic Surgery and Hand Surgery
Hernia
rectus abdominis muscle
transverse rectus abdominis myocutaneous flap
title The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap
title_full The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap
title_fullStr The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap
title_full_unstemmed The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap
title_short The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap
title_sort effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap
topic Hernia
rectus abdominis muscle
transverse rectus abdominis myocutaneous flap
url https://medicaljournalssweden.se/JPHS/article/view/42961
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