J Korean Assoc Maxillofac Plast Reconstr Surg.  2012 Sep;34(5):367-375.

Anatomical Review of Rectus Abdominis Muscle Free Flap for the Oral and Maxillofacial Reconstruction

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Korea. smin5@snu.ac.kr
  • 2Dental Research Institute, School of Dentistry, Seoul National University, Korea.

Abstract

Midfacial reconstruction following resection of extensive malignant oral cavity tumors constitutes a challenging problems for reconstructive surgeons. Rectus abdominis muscle free flap (RAMFF) can be considered as the optimal reconstructive option in this case, because this flap has some advantages including consistent deep inferior epigastric artery anatomy, easy to dissect with well defined skin boundaries, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with oral cancer ablation surgery. The rectus abdominis muscle forms an important part of the anterior abdominal wall and flexes the vertebral column, which is a long strap-like muscle divided transversely by three tendinous intersections, fibrous bands which are adherent to the anterior rectus sheath, which is thickly enclosed by the rectus sheath, except for the posterior part below the arcuate line that is usually located midway between the umbilicus and symphysis pubis. Below the arcuate line, this muscle lies in direct contact with the transversalis fascia and parietal peritoneum. For the better understanding of RAMFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings muse be learned and memorized by the young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the anatomical basis of RAMFF with Korean language.

Keyword

Rectus abdominis muscle free flap (RAMFF); Deep inferior epigastric artery (DIEA); Midface defect; Microvascular anastomosis

MeSH Terms

Abdominal Wall
Alprostadil
Curriculum
Epigastric Arteries
Fascia
Free Tissue Flaps
Humans
Mouth
Mouth Neoplasms
Muscles
Peritoneum
Rectus Abdominis
Skin
Spine
Surgery, Oral
Tissue Donors
Umbilicus
Alprostadil
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