J Korean Soc Plast Reconstr Surg.  2006 Jul;33(4):469-473.

Anatomical Location of the Tendinous Intersections of the Rectus Abdominis Muscle in Korean Women

• Suh HS
• Eom JS
• Lee TJ

Abstract

PURPOSE
The transverse rectus abdominis myocutaneous(TRAM) flap has become a reliable method for autogenous breast reconstruction. However, dissection of the tendinous intersections of rectus abdominis is technically difficult. The tendinous intersection has significant vascularity within its fascial layers raising in importance of technique in elevation. If tendinous intersections are damaged during the elevation of the rectus muscle, circulation to TRAM flap can be endangered. The purpose of this study is to evaluate the number of tendinous intersections and to predict anatomical position of the tendinous intersections.
METHODS
We dissected 182 consecutive TRAM flaps and measured the distance between xiphoid process and each tendinous intersection and evaluated the statistic correlation among the distance, patient's height and position of umbilicus.
RESULTS
In this study, in 30.7% of patients, two tendinous intersections were observed in one rectus abdominis muscle, in 67.7% three tendinous intersections, and in 1.6% four tendinous intersections, respectively. But there was no correlation between patient's height and the distance between xiphoid process and each tendinous intersection.
CONCLUSION
It still remains difficult to predict the position of tendinous intersections just by topography before the dissection. Careful and meticulous dissection of the tendinous intersections is still required.

Keyword

TRAM flap; Tendinous intersection

MeSH Terms

Female
Humans
Mammaplasty
Rectus Abdominis*
Umbilicus