Complications associated with breast reconstruction using a perforator flap compared with a free TRAM flap

This study evaluated the recipient and donor site complications associated with breast reconstruction using a deep inferior epigastric artery perforator flap (DIEAP) flap compared with a free TRAM flap. The charts of 108 patients who underwent breast reconstruction using these techniques were reviewed. There were 130 flaps. Patients with free TRAM flaps had a significantly longer hospital stay (P = 0.003). There were significantly more cases of fat necrosis in the unilateral DIEAP flaps (P = 0.001). In patients who were overweight or obese (body mass index >25 kg/m2), there were significantly more breast complications (P = 0.006). There were more cases of abdominal flap necrosis at the donor site in smokers (P = 0.018) and the diabetic patients (P = 0.013). This study suggests that postoperative complications are related to patient comorbidities, and personal factors and should be considered when selecting the most appropriate reconstructive option.