Home / Photos / Rectus Abdominis Flap (Mathes&Nahai) Flap type – type III muscle and musculocut…
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Rectus Abdominis Flap (Mathes&Nahai) Flap type – type III muscle and musculocut…

Rectus Abdominis Flap (Mathes&Nahai)

Flap type – type III muscle and musculocutaneous

Pedicle – superior epigastric artery from IMA; located deep to medial half of muscle at costal margin; 2cm/1.8mm; and inferior epigastric from external iliac; located deep to lateral half of muscle at level of pubis; 5cm/2.5mm; minor supply from intercostal arteries; segmental motor innervation from intercostal nerves 7-12 enter deep surface at mid to lateral aspect; lateral cutaneous nerves from intercostal nerves 7-12 to skin territory over rectus abdominis

Landmarks – originated from crest of pubis and symphysis of pubis; inserts into rib cartilages 5-7; standard skin island is directly over muscle in a vertical orientation; can also be transverse as TRAM; muscle palpated during contraction between costal margins and pubic rami;
Raise – free flap can be a spectrum of muscle sparing TRAM or as DIEP

Coverage – pedicled to chest, groin, perineum, medial thigh, internal pelvis; free flap

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