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Innervation of the rectus abdominis muscle: implications for rectus flaps. 1988

J Duchateau, and A Declety, and M Lejour
Department of Plastic Surgery, Hôpital Universitaire Brugmann, Brussels, Belgium.

The usefulness of leaving lateral strips of the rectus abdominis muscle in place during a transverse rectus abdominis musculocutaneous (TRAM) flap procedure is questioned. Since textbooks do not agree on the course of the intercostal nerves in the rectus fascia and no precise description is given of the exact site of penetration of the nerves in the rectus muscle, six fresh cadavers were dissected. It has been observed that the nerves enter the deep face of the muscle in its middle portion. Lateral parts of the muscle are consequently denervated during a transverse rectus abdominis musculocutaneous flap, which preserves them. This has been confirmed by CT scan of the abdominal wall in 10 patients 2 to 37 months after a transverse rectus abdominis musculocutaneous flap. In these patients, a progressive fibrosis and disappearance of the remaining muscle could be demonstrated. It is concluded that a partial taking of the rectus abdominis muscle does not preserve its muscular function.

UI MeSH Term Description Entries
D007367 Intercostal Nerves The ventral rami of the thoracic nerves from segments T1 through T11. The intercostal nerves supply motor and sensory innervation to the thorax and abdomen. The skin and muscles supplied by a given pair are called, respectively, a dermatome and a myotome. Intercostal Nerve,Nerve, Intercostal,Nerves, Intercostal
D001940 Breast In humans, one of the paired regions in the anterior portion of the THORAX. The breasts consist of the MAMMARY GLANDS, the SKIN, the MUSCLES, the ADIPOSE TISSUE, and the CONNECTIVE TISSUES. Breasts
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000009 Abdominal Muscles Muscles forming the ABDOMINAL WALL including RECTUS ABDOMINIS; ABDOMINAL OBLIQUE MUSCLES, transversus abdominis, pyramidalis muscles and quadratus abdominis. Cremaster Muscle,Pyramidalis Muscle,Quadratus Abdominis,Transverse Abdominal,Transversus Abdominis,Abdominal Muscle,Abdominal, Transverse,Abdominals, Transverse,Abdomini, Quadratus,Abdominis, Quadratus,Cremaster Muscles,Muscle, Abdominal,Muscle, Cremaster,Muscle, Pyramidalis,Muscles, Abdominal,Muscles, Cremaster,Muscles, Pyramidalis,Pyramidalis Muscles,Quadratus Abdomini,Transverse Abdominals
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps
D013900 Thoracic Nerves The twelve spinal nerves on each side of the thorax. They include eleven INTERCOSTAL NERVES and one subcostal nerve. Both sensory and motor, they supply the muscles and skin of the thoracic and abdominal walls. Pectoral Nerves,Nerve, Pectoral,Nerve, Thoracic,Nerves, Pectoral,Nerves, Thoracic,Pectoral Nerve,Thoracic Nerve
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography

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