Background:
Breast reconstruction is part of continuum of care for patients who undergo mastectomy. The reconstruction options are either autologous or implant based. With the advent of free flaps in breast reconstruction, pedicle flaps such as pedicle Transverse rectus abdominis muscle flap (p TRAM) have slowly been relegated to the periphery. However in many countries there is limited capacity to carry out microsurgical breast reconstruction. We share our experience of patients managed with pedicle Tram flap in such countries.

Objective:
To determine the outcome of patients managed with pedicle Tram flap.

Design:
This was a prospective audit of patients who had mastectomy and reconstructed with pedicle Tram flap in various hospitals in Nairobi, Kenya between January 2015 and December 2022. Variables analyzed were the length of surgery, hospital stay, surgical related complications, and patient’s satisfaction.

Results:
A total of 25 patients had reconstruction with pedicle tram flap from January 2015 to Dec 2022. The mean age for the patient’s was 45.6 years. The average operating time was 4 hours 15 minutes with an average hospital stay of 5.5 days. One patient had partial flap necrosis and one patient had post-surgical wound sepsis. Abdominal hernia was noted in one patient after one year of follow up. Overall patient’s satisfaction was more than 80 percent of the patients.

Conclusion:
Pedicle Tram flap still has a role in the treatment of breast reconstruction. The procedure is less demanding and is associated with good outcomes. It is therefore ideal in centers with limited expertise in free flap based reconstruction.