Rectus Abdominis

Abstract

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].