the use of dermal autograft for fascial repair of tram flap donor sites

closure of fascia after transverse rectus abdominis musculocutaneous (tram) flap has usually been performed with direct closure or synthetic material. the dermal autograft was removed from zone iv of flap was an alternative to reinforce fascial closure. the dermal autograft was used in 34 patients after tram harvest for breast, head and neck reconstruction and prolene mesh was used in 42 other patients for closure of fascial defect. all patients were followed by physical examinations. average follow-up in the dermal autograft group was 27.3 versus 20.7 months in the second group. in the dermal autograft group, one patient complained of bulging of the anterior abdominal wall; one developed a wound infection. in the second group, one patients experienced true hernia. dermal autografts are a useful alternative to mesh repair of fascial defects after tram flap harvest.