Synthetic mesh. Its use in abdominal wall reconstruction after the TRAM.

This technique has evolved over 13 years and has been associated with very few mesh-related complications. A recently reported study of 65 consecutive patients with a mean follow-up of 47.4 months reported a hernia rate of 1.5% (1 of 65) and an incidence of mesh-related infection of 1.5% (1 of 65). It appears that the use of polypropylene (Marlex mesh) offers the reconstructive surgeon several advantages, including elevation of the entire rectus flap, thereby preserving the entire blood supply to the rectus muscle. Second, the interrupted suture technique surrounding the mesh allows for greater distribution of force and diminishes the risk of fascial dehiscence. Therefore, one can obtain a tighter, narrower abdomen to achieve an improved aesthetic abdominal result. The TRAM flap breast reconstruction should not only yield a fine reconstructed breast but also deliver an aesthetic abdominal contour improvement that represents a significant benefit to the patient undergoing this procedure.