Is There a Difference in Abdominal Wall Muscle Strength, Endurance, and Motor Control Following Bilateral DIEP and TRAM Flaps for Breast Reconstruction?

Amra Olafson; Nicole K Le; Lokesh Coomar; Grace Jacobs; Paul Smith; Nazanin Khakpour; Ambuj Kumar; Douglas Haladay; Deniz Dayicioglu

Is There a Difference in Abdominal Wall Muscle Strength, Endurance, and Motor Control Following Bilateral DIEP and TRAM Flaps for Breast Reconstruction?

Eplasty. 2024 May 23:24:e30. eCollection 2024.

Authors

Amra Olafson¹, Nicole K Le¹, Lokesh Coomar², Grace Jacobs³, Paul Smith^{1

4}, Nazanin Khakpour⁴, Ambuj Kumar⁵, Douglas Haladay⁶, Deniz Dayicioglu^{1

4}

Affiliations

¹ Department of Plastic Surgery, Morsani College of Medicine, University of South Florida, Tampa, Florida.
² Center for Anatomical Science and Education, Department of Surgery, Saint Louis University School of Medicine, St Louis, Missouri.
³ Morsani College of Medicine, University of South Florida, Tampa, Florida.
⁴ Department of Women's Oncology, Breast Program, Moffitt Cancer Center, Tampa, Florida.
⁵ University of South Florida, Morsani College of Medicine, Department of Health Outcomes and Behavior, Tampa, Florida.
⁶ USF Morsani College of Medicine Physical Therapy and Rehabilitation Sciences; Tampa, Florida.

PMID: 38846507
PMCID: PMC11155377

Abstract

Background: Abdominal donor site complications in bilateral pedicled transverse rectus abdominis muscle (TRAM) have been a concern when compared with bilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction. This study aimed to assess the strength, endurance, and motor control in patients undergoing DIEP and TRAM flaps.

Methods: A prospective, cohort study was performed at a single institution including patients who underwent pedicled TRAM and DIEP flap reconstruction after mastectomy from August 2017 to August 2018. Patients underwent pre- and postoperative testing involving rectus abdominis, prone plank, side bridge, and trunk flexor tests. Descriptive analyses and multivariate linear regressions were performed.

Results: The final analysis included a total of 9 patients, 4 of whom underwent TRAM flap reconstruction while 5 underwent DIEP flap reconstruction. The tests were not statistically significant between the TRAM versus DIEP groups, including rectus abdominis mean time decrease (0.25 vs 0.60 sec, P = .51), prone plank time increase (1.38 vs 1.38 sec, P = .51), right side bridge time increase (7.54 sec vs 32.15 sec, P = 1.00), left side bridge time increase (2.14 vs 44.5 sec, P = .37), and trunk flexor time decrease (4.68 vs 1.68 sec, P = .44). Overall complications were similar between the 2 groups.

Conclusions: No significant difference in abdominal donor site morbidity was found when comparing the 2 groups. This article provides a point of conversation with patients when discussing available reconstruction options.

Keywords: Abdominal; DIEP; Function; Reconstruction; TRAM.

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