Pulmonary function after pedicled transverse rectus abdominis musculocutaneous flap breast reconstruction

Kevin J. Shultz, Scott Don, Raman C. Mahabir, Charles N. Verheyden

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Tight abdominal closures, as can be seen during transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction, have been shown to increase intra-abdominal pressure, thereby decreasing thoracopulmonary compliance and increasing the workload of breathing. The purpose of this article was to quantitate pulmonary function in patients who underwent pedicled TRAM flap breast reconstruction. A prospective clinical trial was conducted involving 22 women undergoing unilateral or bilateral pedicled TRAM flap breast reconstruction. Pulmonary function testing was conducted 1 week before the operation, 24 hours postoperatively, and 2 months postoperatively. The patients were stratified by age (<50 years vs ≥50 years), type of TRAM flap (unilateral vs bilateral), tobacco use (smoker vs nonsmoker), and body mass index. Changes were analyzed using 1-way repeated-measures analysis of variance and paired t tests. All comparisons used a 2-tailed test at the 0.05 level of significance. Other than residual volume, the 24-hour postoperative values were significantly lower than the preoperative values. The smokers had less change in functional residual capacity, total lung capacity, and forced vital capacity values than the nonsmokers at 24 hours postoperatively; however, they were noted to have decreased pulmonary function at baseline. The patients 50 years or older had significantly greater decline in functional residual capacity and residual volume compared with the younger cohort. No significant difference in pulmonary function testing values existed between those undergoing bilateral versus unilateral pedicled TRAM flap reconstruction. Pulmonary function tests returned to baseline at 2-month follow-up. Pulmonary function test values were significantly decreased at 24 hours after pedicled TRAM flap breast reconstruction.

Original languageEnglish (US)
Pages (from-to)106-109
Number of pages4
JournalAnnals of Plastic Surgery
Volume77
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Rectus Abdominis
Myocutaneous Flap
Mammaplasty
Lung
Functional Residual Capacity
Residual Volume
Respiratory Function Tests
Total Lung Capacity
Vital Capacity
Tobacco Use
Workload
Compliance
Analysis of Variance
Respiration
Body Mass Index
Clinical Trials
Pressure

Keywords

  • breast reconstruction
  • intra-abdominal pressure
  • lung
  • pulmonary function
  • TRAM

ASJC Scopus subject areas

  • Surgery

Cite this

Pulmonary function after pedicled transverse rectus abdominis musculocutaneous flap breast reconstruction. / Shultz, Kevin J.; Don, Scott; Mahabir, Raman C.; Verheyden, Charles N.

In: Annals of Plastic Surgery, Vol. 77, No. 1, 01.01.2016, p. 106-109.

Research output: Contribution to journalArticle

Shultz, Kevin J. ; Don, Scott ; Mahabir, Raman C. ; Verheyden, Charles N. / Pulmonary function after pedicled transverse rectus abdominis musculocutaneous flap breast reconstruction. In: Annals of Plastic Surgery. 2016 ; Vol. 77, No. 1. pp. 106-109.
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