{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:26:30Z","timestamp":1767713190697,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The purpose of this study was to introduce a new surgical technique for pedicled TRAM flap that removes a part of the rectus abdominis muscle inserting into ribs, and to analyze this technique in comparison with classical pedicled TRAM flap. Methods: A retrospective review of patient charts from May 2006 to February 2016 was performed. The patient group that underwent the removal of the part of the rectus abdominis that inserts into the thorax (partial muscle resection; PMR group) was compared with the group that did not undergo this muscle resection (Classical group). The complications and aesthetic effects of surgery between the two groups were analyzed. Results: There were 34 patients in the classical group and 28 in the PMR group. There were no significant differences in postoperative complications between these two groups. The rates of fat necrosis were 32.1% in the PMR group and 36.1% in the classical group. The postoperative aesthetic outcome of the inframammary fold showed no significant differences in outcome between the classical and PMR groups. However, all items received higher scores in the PMR group. Conclusions: The authors\u2019 new surgical method was associated with a positive cosmetic effect of improving inframammary fold aesthetics and could thus represent a new option for pTRAM breast reconstruction.<\/jats:p>","DOI":"10.3390\/jcm11226647","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T02:07:48Z","timestamp":1668046068000},"page":"6647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Partial Removal of Rectus Abdominis Muscle Inserting into Ribs in Ipsilateral Pedicled TRAM Flap for Breast Reconstruction"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4653-1048","authenticated-orcid":false,"given":"Daegu","family":"Son","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu 42601, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaehoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu 42601, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/00006534-198202000-00006","article-title":"Breast reconstruction with a transverse abdominal island flap","volume":"69","author":"Hartrampf","year":"1982","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1097\/00006534-198805000-00012","article-title":"The superiorly based rectus abdominis flap: Predicting and enhancing its blood supply based on an anatomic and clinical study","volume":"81","author":"Miller","year":"1988","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1097\/00006534-199512000-00015","article-title":"TRAM flap vascular delay for high-risk breast re construction","volume":"96","author":"Codner","year":"1995","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1097\/00006534-199705010-00035","article-title":"A hemodynamic approach to clinical results in the TRAM flap after selective delay","volume":"99","author":"Ribuffo","year":"1997","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"729181","DOI":"10.3389\/fsurg.2022.729181","article-title":"Patient Management Strategies in Perioperative, Intraoperative, and Postoperative Period in Breast Reconstruction With DIEP-Flap: Clinical Recommendations","volume":"9","author":"Chen","year":"2022","journal-title":"Front Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Chen, K., Zhang, J., Beeraka, N.M., Sinelnikov, M.Y., Zhang, X., Cao, Y., and Lu, P. (2022). Robot-Assisted Minimally Invasive Breast Surgery: Recent Evidence with Comparative Clinical Outcomes. J. Clin. Med., 11.","DOI":"10.3390\/jcm11071827"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0094-1298(20)30744-6","article-title":"The pedicled TRAM as preference for immediate autogenous tissue breast reconstruction","volume":"21","author":"Beasley","year":"1994","journal-title":"Clin. Plast. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0094-1298(20)32495-0","article-title":"Breast reconstruction with a pedicled TRAM flap","volume":"25","author":"Shestak","year":"1998","journal-title":"Clin. Plast. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/00000637-198402000-00008","article-title":"Abdominal wall competence in transverse abdominal island flap operations","volume":"12","author":"Hartrampf","year":"1984","journal-title":"Ann. Plast. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/00006534-199507000-00016","article-title":"Rectus abdominis muscle innervation: Implications for TRAM flap elevation","volume":"96","author":"Hammond","year":"1995","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/0007-1226(87)90039-7","article-title":"Augmentation of circulation of pedicled transverse rectus abdominis musculocutaneous flaps by microvascular surgery","volume":"40","author":"Harashina","year":"1987","journal-title":"Br. J. Plast. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1097\/00006534-199406000-00012","article-title":"Bilateral breast reconstruction: Conventional versus free TRAM","volume":"93","author":"Baldwin","year":"1994","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1097\/00006534-199909010-00009","article-title":"A comparison of pedicled and free TRAM flaps for breast reconstruction in a single institution","volume":"104","author":"Larson","year":"1999","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1097\/00006534-200112000-00017","article-title":"Outcome comparison between free and pedicled TRAM flap breast reconstruction in the obese patient","volume":"108","author":"Moran","year":"2001","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/PRS.0b013e3181c2a620","article-title":"Outcomes and patient satisfaction following breast recon struction with bilateral pedicled TRAM flaps in 105 consecutive patients","volume":"125","author":"Chun","year":"2010","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.breast.2017.12.003","article-title":"Meta-analysis of flap perfusion and donor site complications for breast reconstruction using pedicled versus free TRAM and DIEP flaps","volume":"38","author":"Jeong","year":"2018","journal-title":"Breast"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"651e","DOI":"10.1097\/PRS.0000000000003768","article-title":"Evidence-based clinical practice guideline: Autologous breast reconstruction with DIEP or pedicled TRAM abdominal flaps","volume":"140","author":"Lee","year":"2017","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/00006534-198808000-00001","article-title":"Innervation of the rectus abdominis muscle: Implications for rectus flaps","volume":"82","author":"Duchateau","year":"1988","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.bjps.2020.01.010","article-title":"The island-type pedicled TRAM flap: Improvement of the aesthetic out comes of breast reconstruction","volume":"73","author":"Yoon","year":"2020","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1097\/00006534-198312000-00034","article-title":"Tailoring of the new breast using the transverse abdominal island flap","volume":"72","author":"Elliott","year":"1983","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/00000637-199812000-00007","article-title":"Intraoperative vascular monitoring of ipsilateral vs. contralateral TRAM flaps","volume":"41","author":"Clugston","year":"1998","journal-title":"Ann. Plast. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/00000637-199804000-00005","article-title":"Preferential use of the ipsilateral pedicle in TRAM flap breast reconstruction","volume":"40","author":"Olding","year":"1998","journal-title":"Ann. Plast. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/SAP.0b013e318248b643","article-title":"Impact of prior ipsilateral chest wall radiation on pedicled TRAM flap breast reconstruction","volume":"71","author":"Chun","year":"2013","journal-title":"Ann. Plast. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.cps.2006.11.014","article-title":"The pedicled TRAM flap in breast reconstruction","volume":"34","author":"Jones","year":"2007","journal-title":"Clin. Plast. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s00266-011-9774-0","article-title":"Preferred use of the ipsilateral pedicled TRAM flap for imme diate breast reconstruction: An illustrated approach","volume":"36","author":"Tan","year":"2012","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1177\/229255031101900101","article-title":"An investigation of the application of laser-assisted indocyanine green fluorescent dye angiography in pedicle transverse rectus abdominus myocutaneous breast reconstruction","volume":"19","author":"Newman","year":"2011","journal-title":"Can. J. Plast. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1097\/00006534-199106000-00007","article-title":"Abdominal wall function after rectus abdominis transfer","volume":"87","author":"Lejour","year":"1991","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"359","DOI":"10.5999\/aps.2013.40.4.359","article-title":"Anatomical and functional recovery of neurotized remnant rectus abdominis muscle in muscle-sparing pedicled transverse rectus abdominis musculocutaneous flap","volume":"40","author":"Jeong","year":"2013","journal-title":"Arch. Plast. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/22\/6647\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:13:22Z","timestamp":1760145202000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/22\/6647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,9]]},"references-count":28,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["jcm11226647"],"URL":"https:\/\/doi.org\/10.3390\/jcm11226647","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,11,9]]}}}