Pedicel tram and latissimus dorsi muscle reconstruction after mastectomy

First to use the anterior transfer of Latissimus dorsi (LD) muscle for covering anterior chest defect after breast amputation was Iginio Tansini in 1897. Not until the 70es this flap was mostly used as salvage procedure for covering defects of pectoral area. With increased understranding of cutaneus vasculature and McCraw's introduction of myocutaneus flap concept, Olivari (1976), Olbrisch (1977) and Bostwick (1977) popularized the LD flap in breast reconstruction. Few years later pedicled TRAM based on superor epigastric artery was introduced by Hartrampf (1982). Both flaps permit fully autologous reconstructio…