[Preliminary dissection of the blood supply on myocutaneous flap of rectus abdominis on hypogastric zone].
OBJECTIVE
To investigate the location of the artery correlated with rectus abdominis musculocutaneous flap in order to promote the reconstruction of the breast after radical mastectomy for breast cancer.


METHODS
An anatomic study was carried out on 15 cadavers of 30 sides, which were immersed in paraformaldehyde less than six months. Whole thorax-epigastric wall was cutterd, which scale was from subclavian as upper limit to inguinal ligament, the lower limit across left and right of middle axillary. Veins or arteries of inferior epigastric and internal thorax in hang were injected with red or blue ink to show all of vessel branches.


RESULTS
The external diameters of both the superior epigastric arteries and inferior vessels were 1.87 +/- 0.28 mm and 2.25 +/- 0.32 mm respectively. The myocutaneous arteries from inferior abdomen vessels had an intensive horizontal distribution on hilum. The perforators significantly decreased but could be found to pass through anterior rectus sheath in Rand. The distances between lateral perforators and I , II and III parts in external edge of anterior rectus sheath were 1.22, 1.46 and 1.57 cm, respectively; and the distances between medial perforators and I, II, and III parts at median line were 1.54, 1.62, 1.66 cm. Perforators were more thick and intensive near hilum than in other part. The subcostal arteries derived from inferior abdomen artery and 1.25 +/- 0.37 cm away from costal arch. After dividing into subcostal artery, the outer diameter of 67 percent of subcostal artery was bigger than that of inferior abdomen arteries. The branches of subcostal arteries were distributed at the 2/3 lateral rectus abdominis, forming an extensive choke anastomosis system with intercostal anterior artery and vessels supplied diaphragmatic muscle. The rectus abdominis at the level of xyphoid was supplied by a branch came from inferior thorax artery, which diverged epigastric vessels at the same time.


CONCLUSIONS
During the process of making the inferior transverse rectus abdominis musculocutaneous flap base on superior epigastric vessels and superior rectus abdominis, reservation of pro-theca edge 1 cm of rectus abdominis can protect inferior abdomen artery from injury. Reservation of more than 2 cm pro-theca and rectus abdominis below costal arch at the flag will protect effectively subcostal artery from injury. No damage of subcostal arteries can influence the survival of musculocutaneous flap.
Shao
Yuguo
Y
Department of Breast, the International Peace and Maternal and Child Health Hospital, Shanghai, P R China. wu-zhixiang@hotmail.com
Zhou
Xiaoyun
X
Hu
Xiuquan
X
D034861:Abdominal Wall; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000033:anatomy & histology; D008875:Middle Aged; D017568:Rectus Abdominis / Q000098:blood supply*; D013524:Surgical Flaps / Q000098:blood supply*