Developing a Breast Reconstruction Program in a Resource-Constrained Ghanaian Teaching Hospital Needs Assessment and Implementation

Joshua T. Tieman, Maziar Mohsen Nourian, Pius Agbenorku, Paa Ekow Hoyte-Williams,Boutros Farhat, Isak A. Goodwin, Lukasz Swistun, Kenneth Bo Foreman, William Bradford Rockwell

ANNALS OF PLASTIC SURGERY(2021)

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摘要
As the detection of breast cancer in Ghana improves, the incidence of mastectomy has increased and the outcomes have improved. As a secondary result, the need for breast reconstruction is increasing. The cultural hesitation to undergo a mastectomy and live without a breast can be decreased by making breast reconstruction available, cost-effective, and acceptable. Cultural, economic, and technical factors were considered in choosing the best method of breast reconstruction. Discussions, lectures, and cadaver dissections investigated the various reconstructive options. Operative cases were performed using a latissimus musculocutaneous flap, a lower abdominal transverse rectus abdominis myocutaneous (TRAM) flap, and a midabdominal TRAM flap. The midabdominal TRAM was lbund to be the best choice at Komfo Anokye Teaching Hospital. It is a reliable, robust, well-perfused, single-stage flap that produced excellent patient satisfaction.
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breast,reconstruction,Ghana,TRAM
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