title: Anatomical variation in deep inferior epigastric pedicles and implications for harvest of lower abdominal flaps.
abstract: The transverse rectus abdominis musculocutaneous (TRAM) flap based on the deep inferior epigastric artery is useful in head and neck reconstruction as it provides substantial skin and soft tissue cover, and allows volume to be replaced in large defects. A major advantage is the anatomical reliability of the deep inferior epigastric pedicle. We report a case in which neither rectus abdominis muscles had a blood supply from the deep inferior epigastric artery, which necessitated a change in the planned reconstruction. We review variations in the anatomical course of the artery and, although rare, stress the importance of reconstructive surgeons being aware of such variations.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, UK. hyder.ridha@gmail.com
authors.forename: Hyder
authors.initials: H
authors.lastname: Ridha
authors.forename: Mark K
authors.initials: MK
authors.lastname: Thompson
authors.forename: Malcolm G
authors.initials: MG
authors.lastname: Cameron
authors.forename: Amer J
authors.initials: AJ
authors.lastname: Durrani
mesh_terms: D000328:Adult; D019074:Epigastric Arteries / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008339:Mandibular Neoplasms / Q000601:surgery*; D009381:Neoplasms, Radiation-Induced / Q000601:surgery; D012516:Osteosarcoma / Q000601:surgery*; D017568:Rectus Abdominis / Q000098:blood supply*; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting