Functional and ultrasound evaluation of donor site morbidity after TRAM flap for breast reconstruction

In 22 patients free TRAM, DIEP or pedicled TRAM flap was used for breast reconstruction. For evaluation of donor site morbidity ultrasound and functional testing by Janda was used. The ultrasound investigation revealed contractibility grade 2 and 3 of the remaining rectos muscle in 11 patients mainly after DIEP and unilateral free TRAM. These patients reached Janda 4 and 5 in clinical evaluation. All patients after unilateral pedicled TRAM flap reached Janda 5 although no muscle contractibility was left. Ultrasound as a dynamic imaging method is useful for examination of contractibility and movements in the remaining rectos muscle.