Thermal injury to TRAM flaps: a report of five cases.

Five cases of burns occurring in TRAM flaps utilized for breast reconstruction are presented in this study. These injuries resulted from exposure to thermal and/or solar radiation. We believe that the physiologic changes that result from flap elevation and transposition, mainly denervation, negate the autonomic protective mechanisms for heat dissipation. This renders the flaps more susceptible to injury from these energy forms. Because of these findings, we urge all plastic surgeons who perform TRAM flap reconstructions to carefully instruct their patients to avoid exposing their flaps to heat and solar radiation.