Rectus Abdominis

  • Ralph T. Manktelow


In reconstructive flap surgery, there is considerable interest in the epigastric artery axis. This axis, supplied above by the superior epigastric artery and below by the deep inferior epigastric artery (DIEA), supplies the rectus abdominis muscle and a huge area of abdominal skin. Its value for pedicled flaps based on the superior vessel was particularly appreciated by Brown, Mathes and McCraw. Its most common application on the superior vessel is for breast reconstruction as a myocutaneous flap. Usually the skin flap is taken from the lower abdomen, in the abdominoplasty region [4,5,7,9]. The ability of the superior epigastric artery to carry all of the ipsilateral lower abdominal skin and at least half of the contralateral skin has amazed reconstructive surgeons. However, increasing experience has shown that, when using the superior epigastric artery, the higher the skin flap is based on the rectus musculature the more reliable is its perfusion. Since the DIEA is twice the diameter of the superior epigastric artery and is the dominant blood supply to the rectus abdominis muscle, the DIEA is the preferred pedicle for free tissue transfer [3, 8].


Skin Flap Rectus Muscle Rectus Sheath Myocutaneous Flap Rectus Abdominis Muscle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Boyd JB, Taylor GI, Corlett R (1984) The vascular territories of the superior epigastric and the deep inferior epigastric systems. Plast Reconstr Surg 73: 1PubMedCrossRefGoogle Scholar
  2. 2.
    Brown RG, Vasconez LO, Jurkiewicz MJ (1975) Transverse abdominal flaps and the deep epigastric arcade. Plast Reconstr Surg 55: 416PubMedCrossRefGoogle Scholar
  3. 3.
    Bunkis J, Walton RL, Mathes SJ (1983) The rectus abdominis free flap for lower extremity reconstruction. Ann Plast Surg 11: 373PubMedCrossRefGoogle Scholar
  4. 4.
    Drever, JM (1981) Total breast reconstruction. Ann Plast Surg 7: 54PubMedCrossRefGoogle Scholar
  5. 5.
    Hartrampf CR, Scheflin M, Black KW (1982) Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg 69: 216PubMedCrossRefGoogle Scholar
  6. 6.
    Mathes SJ, Bostwick J III. (1977) A rectus abdominis myocutaneous flap to reconstruct abdominal wall defect. Br J Plast Surg 30: 282PubMedCrossRefGoogle Scholar
  7. 7.
    McCraw JB, Dibbell DJ, Carraway JH (1977) Clinical definition of independent myocutaneous vascular territories. Plast Reconstr Surg 60: 341PubMedCrossRefGoogle Scholar
  8. 8.
    Pennington DG, Lai MF, Pelly AD (1980) The rectus abdominis myocutaneous free flap. Br J Plast Surg 33: 277PubMedCrossRefGoogle Scholar
  9. 9.
    Robbins TH (1979) Rectus abdominis myocutaneous flap for breast reconstruction. Aust NZ J Surg 49: 527CrossRefGoogle Scholar
  10. 10.
    Taylor GI, Corlett R, Boyd JB (1983) The extended deep inferior epigastric flap: a clinical technique. Plast Reconstr Surg 72: 751PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • Ralph T. Manktelow
    • 1
    • 2
  1. 1.Faculty of MedicineUniversity of TorontoTorontoCanada
  2. 2.Division of Plastic SurgeryToronto General HospitalTorontoCanada

Personalised recommendations