Lymphology Association of North America (LANA) Practice Exam

What is the recommended waiting time for abdominal manual lymphatic drainage (MLD) after a TRAM flap?

1. 1 month

2. 3-6 months

3. 6-9 months

4. More than 12 months

The correct answer is: 3-6 months

The recommended waiting time for abdominal manual lymphatic drainage (MLD) after a TRAM flap procedure is typically 3-6 months. This period allows for sufficient healing and recovery following the surgery, which involves the transfer of abdominal tissue to reconstruct the breast. During this initial recovery phase, the body undergoes various healing processes, and lymphatic drainage may still be compromised due to surgical trauma and edema. After a TRAM flap, lymphatic pathways can be disrupted, leading to potential fluid accumulation and lymphedema. However, starting MLD too soon may interfere with natural healing and could exacerbate complications. Waiting for 3-6 months ensures that the surgical site has stabilized and allows for increased circulation and lymphatic function before applying manual techniques to promote drainage and reduce swelling effectively. This timeframe strikes a balance between ensuring adequate healing and activating the lymphatic system to restore fluid balance in the affected areas. By this time, the individual is often more responsive to MLD, making it a vital aspect of postoperative care to enhance recovery and minimize the risk of lymphedema.