Comparative analysis of breast reconstruction outcomes using TRAM and DIEP flaps after mastectomy

Objective. To compare clinical and aesthetic outcomes of breast reconstruction using Transverse Rectus Abdominis Myocutaneous (TRAM) and Deep Inferior Epigastric Perforator (DIEP) flaps after mastectomy. Material and methods. The study involved patients diagnosed with stage I, II, and IIIA breast cancer who underwent total mastectomy. There were 28 patients. Of these, 18 ones underwent DIEP flap reconstruction, 10 — TRAM flap reconstruction. Clinical evaluations and patient-reported outcomes were accessed to figure out the effectiveness of each surgical approach concerning aesthetic satisfaction and quality of life. Results. The study found no significant difference in timing of reconstruction (immediate vs. delayed) between two flaps. However, patients with DIEP flaps reported higher satisfaction with breast aesthetics and quality of life, better psychological and social health outcomes. Despite these benefits, DIEP flaps showed higher incidence of partial and complete necrosis compared to TRAM flaps. Conclusion. DIEP flaps are supposed to have superior aesthetic outcomes and enhanced quality of life despite slightly higher complication rate. These findings emphasize the importance of meticulous patient selection and surgical planning to improve reconstruction results. Future studies with substantial number of patients are required to further refine flap selection criteria, reduce complications and improve patient satisfaction.