What does VRAM flap stand for?
Abstract. Vertical rectus abdominis mycutaneous (VRAM) flap provides a reliable flap cover for large soft tissue defects of chest wall, torso, groin, perineum and thigh. It has been mainly used in trauma and benign conditions.
What is a pedicled muscle flap?
Pedicled Flaps. Pedicled flaps transfer tissue from one part of the body to another by rotating around an intact vascular pedicle. Transverse rectus abdominis myocutaneous (TRAM) and latissimus dorsi flaps are the most common pedicle flaps used to reconstruct the breast.
What is a tissue flap?
A flap is a transfer of tissue with its intrinsic blood supply from one part of the body to another. The blood supply to a flap is persistent and does not depend on the recipient bed.
What is axial flap?
An axial pattern flap is a pedicle graft that incorporates a direct cutaneous artery and vein into its base. Island arterial flaps can be developed from axial pattern flaps by dividing the cutaneous pedicle, but preserving the direct cutaneous artery and vein entering the newly created “skin island”.
What is VRAM reconstruction?
The vertical rectus abdominis myocutaneous (VRAM) flap is an established technique employed to reconstruct pelvic and perineal defects not amenable to primary closure.
What is Diep procedure?
A DIEP (pronounced like deep) flap is a type of reconstruction that uses a woman’s own tissue to create a new breast after a mastectomy. The surgery’s tongue-twister of a name comes from the branches of the primary blood vessel relocated during the procedure, the deep inferior epigastric perforator (DIEP).
What is an alt flap?
The anterolateral thigh (ALT) flap (Fig. 26.3) is a very popular flap for lower limb reconstruction for several reasons. It is based on an area of skin and fascia on the anterolateral aspect of the thigh supplied by perforators of the descending branch of the lateral circumflex femoral artery.
What is an Autoderm flap?
Autologous de-epithelialized dermis is used to provide secondary inferior pole protection by creating a fully vascularized pocket of pectoral muscle and sling underneath Wise pattern reduction mastectomy flaps.
Why is the VRAM flap preferred for pelvic reconstruction?
The VRAM flap is preferred for pelvic reconstruction because it is a composite myocutaneous flap consisting of three layers: skin, subcutaneous fat, and muscle. This triple-layer anatomy makes the VRAM flap durable, and the flap can be used to cover skin defects.
What are omental Pedicle flaps and VRAM flaps?
VRAM and omental pedicle flaps are often used in tandem in pelvic reconstruction, with the omental pedicle flap used to fill the pelvic dead space and the VRAM flap used for closure of perineal and (in some cases) vaginal defects.
What does a vram flap look like on CT?
Computed Tomography.— At initial postoperative CT, a VRAM flap used to reconstruct the pelvic floor appears as an arcuate band or island of soft tissue in the pelvis that is isoattenuating relative to muscle. When a VRAM flap is used to reconstruct the vagina, the flap may not be very noticeable at imaging.
Why is the VRAM flap not used in obese patients?
Also, in obese patients the VRAM flap may be too bulky to be placed intraorally, and so in these situations some surgeons use only the rectus abdominis muscle, with skin grafting.