Skin-preserving radical mastectomy with simultaneous breast reconstruction with a free MS-Tram flap on microsurgical anastomoses

Introduction. Together with the development of the methods for surgical removal of the breast the methods of its restoration have been improving as well. It should be considered that the purpose of a breast reconstruction is to recreate a natural, plastic form and maximum symmetry, so the surgical treatment is chosen individually, taking into account the patient's anamnesis and anatomical features. These tasks allow solving various methods of autologous reconstruction, where flaps of the anterior abdominal wall (both in a single-stage and in a delayed version) are gold standards today. The question of the degree of injury to the donor zone is one of the important links while choosing a flap harvesting option. Discussion. The article presents a clinical case and describes in detail the simultaneous reconstruction with a free MS-TRAM flap (Muscle-Sparing Transverse Rectus Abdominis Myocutaneous flap) - a muscle-sparing variant of flap lifting, which is a good alternative to the DIEP flap in case of technical difficulties, coming from the topographic and anatomical features of vessels and occurring during a surgery. Conclusions. This technique reduces the likelihood of postoperative complications at the donor zone and, in some cases, may exclude the use of a mesh implant. There is no substantial difference in performing the "sit-up" test during the postoperative period in the case of transplantation of DIEP and MS-TRAM flaps.