What is a rectus abdominis flap?

The rectus flap is a musculocutaneous flap based on the deep inferior epigastric artery and vein and terminal musculocutaneous perforators. These vessels arise from the external iliac artery and vein and course superomedially to run along the deep lateral aspect of the muscle.

What is myocutaneous flap?

Myocutaneous flaps are compound flaps with a solitary vascular supply incorporating skin, subcutaneous tissue, fascia, and the underlying muscle. Once a pedicled or free-tissue transfer is performed, the newly transferred flap begins to incorporate into the surrounding tissue.

What is vertical rectus abdominis myocutaneous flap?

The extended vertical rectus abdominis myocutaneous (eVRAM) flap is useful to obtain additional skin and fat with the distal (superior) flap for pelvic or perineal reconstruction. The eVRAM flap requires sufficient laxity of the abdominal wall for donor site closure.

What is a trans flap surgery?

A DIEP (pronounced like deep) flap is a type of reconstruction that uses a woman’s own tissue to create a new breast after a mastectomy. The surgery’s tongue-twister of a name comes from the branches of the primary blood vessel relocated during the procedure, the deep inferior epigastric perforator (DIEP).

What is an alt flap?

The anterolateral thigh (ALT) flap (Fig. 22-4) is a very popular flap for lower limb reconstruction for several reasons. It is based on an area of skin and fascia on the anterolateral aspect of the thigh supplied by perforators of the descending branch of the lateral circumflex femoral artery.

What is a Sartorius flap?

The sartorius muscle flap is performed by mobilizing the muscle along its lateral edge to preserve the medially based blood supply. (The most cephalad vascular supply is approximately 6.5 cm distal to the anterior superior iliac spine.) The muscle is then divided at its origin from the anterior superior iliac spine.

How long does it take for a muscle flap to heal?

It takes approximately two months for swelling and bruising to go away and up to two years for tissues to heal. Patients should plan to wear a surgical bra for six to eight weeks and to refrain from heavy exercise and certain sexual activities during this time.

What part of the hip does the rectus abdominis attach to?

Origin and insertion Inferiorly the rectus abdominis muscle is attached by two tendons; the larger one is attached to the pubic crest, from the pubic tubercle to the pectineal line, while the small, medial tendon is attached to the pubic symphysis.

What does superior epigastric artery supply?

Function. Where it anastomoses, the superior epigastric artery supplies the anterior part of the abdominal wall, upper rectus abdominis muscle, and some of the diaphragm.

Is TRAM flap same as tummy tuck?

Because skin, fat, muscle, and blood vessels are moved from the belly to the chest, having a TRAM flap means your belly will be flatter and tighter — as if you had a tummy tuck.

How long does flap surgery take?

The tiny blood vessels in the flap, which will feed the tissue of your new breast, are matched to blood vessels in your chest and carefully reattached under a microscope. DIEP flap reconstruction surgery takes about 6 to 8 hours.

Is the rectus abdominis used for a TRAM flap?

Pedicled TRAM flaps almost always use a large portion of the rectus abdominis muscle and are known as “muscle-transfer” flaps. Recovering from a pedicled TRAM flap can take longer than recovering from a muscle-sparing free TRAM flap because more muscle is used.

How is the flap of the rectus myocutaneous performed?

With the patient in the supine position and the knees slightly flexed, the skin should be able to be pinched closed. The flap is started by elevating from lateral to medial and the search for perforators is begun when the rectus sheath over the muscle is encountered.

How is the rectus abdominis used in breast reconstruction?

Transverse rectus abdominis musculocutaneous flap. An autologous myocutaneous flap consisting of abdominal skin, subcutaneous fat, the rectus abdominis muscle, and adjoining vasculature is used for reconstruction of the breast following mastectomy.

What kind of flap is used for breast reconstruction?

Transverse rectus abdominis musculocutaneous flap. Transplantation of a transverse rectus abdominis myocutaneous (TRAM) flap is a commonly used surgical procedure for breast reconstruction following mastectomy. An autologous myocutaneous flap consisting of abdominal skin, subcutaneous fat, the rectus abdominis muscle,…