Evidence-based clinical practice guideline: Autologous breast reconstruction with DIEP or pedicled TRAM abdominal flaps

Bernard T. Lee, Jayant P. Agarwal, Jeffrey A. Ascherman, Stephanie A. Caterson, Diedra D. Gray, Scott T. Hollenbeck, Seema A. Khan, Lauren D. Loeding, Raman C. Mahabir, Archibald S. Miller, Galen Perdikis, Jaime S. Schwartz, Beth A. Sieling, Achilles Thoma, Judith A. Wolfman, Jean L. Wright

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


The American Society of Plastic Surgeons commissioned a multi-stakeholder Work Group to develop recommendations for autologous breast reconstruction with abdominal flaps. A systematic literature review was performed and a stringent appraisal process was used to rate the quality of relevant scientific research. The Work Group assigned to draft this guideline was unable to find evidence of superiority of one technique over the other (deep inferior epigastric perforator versus pedicled transverse rectus abdominis musculocutaneous flap) in autologous tissue reconstruction of the breast after mastectomy. Presently, based on the evidence reported here, the Work Group recommends that surgeons contemplating breast reconstruction on their next patient consider the following: the patient’s preferences and risk factors, the setting in which the surgeon works (academic versus community practice), resources available, the evidence shown in this guideline, and, equally important, the surgeon’s technical expertise. Although theoretical superiority of one technique may exist, this remains to be reported in the literature, and future methodologically robust studies are needed.

Original languageEnglish (US)
Pages (from-to)651e-664e
JournalPlastic and reconstructive surgery
Issue number5
StatePublished - 2017

ASJC Scopus subject areas

  • Surgery


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