DIEP flap

Pedicled TRAM

The abdominal ellipse of skin can be transferred to the chest wall by tunnelling it up underneath the upper abdominal tissues and not detaching it from its blood supply. This procedure is known as a pedicled tram and has a limited place in modern breast reconstruction. Although it avoids the risk of micro vascular complications the blood supply is not as good and there is an increased risk of other complications particularly poor wound healing.