TRAM Flap in Breast Reconstruction: A Forgotten Technique? Case Report Series at A Breast Cancer Referral Center in Southern Mexico City

With the evolution of microsurgery and the development of the DIEP flap, muscle preservation has become the new gold standard in many centers (1). However, the availability of microsurgical resources is not universal, and not all patients are ideal candidates for prolonged procedures. In this context, the pedicled TRAM flap retains its relevance as a reconstructive strategy dependent on the clinical and institutional context (2). This paper presents four cases of breast reconstruction using the TRAM flap, evaluating age, operative time, length of hospital stay, postoperative outcomes, and complications. The pedicled TRAM flap relies on vascularization from the superior epigastric arteries, which allows the transfer of abdominal tissue without the need for microvascular anastomosis.