title: [Lengthened pedicle of rectus abdominis flap to repair defect on neck and chest].
abstract: OBJECTIVE
  To explore the feasibility to repair defect on the neck and chest with the rectus abdominis flap which pedicle is lengthened by measuring the width, thickness, and the intercostal space of the inferior costicartilage using CT angiography (CTA).
  
  
  METHODS
  Thirty cases receiving CTA and three-dimensional reconstruction between July and December 2013 were included in the study. Of 30 cases, 17 were male and 13 were female, aged 44-70 years (mean, 56 years). The width and thickness of the 3rd to 7th costicartilages and the distance of the 3rd to 6th intercostal spaces were measured, and the lengthened pedicle was calculated after the 4th to 7th costicartilage was cut off. Between July 2012 and November 2013, the lengthened pedicle of the rectus abdominis flap was clinically used to repair the defect on the neck and chest in 4 cases.
  
  
  RESULTS
  The pedicle of the rectus abdominis flap was about 6 cm in length. When the left 7th, 6th, 5th, and 4th costicartilages were cut off, the average pedicle was lengthened by 4.07, 7.99, 12.50, and 17.48 cm respectively; when the right 7th, 6th, 5th, and 4th costicartilages were cut off, the average pedicle was lengthened by 4.63, 10.82, 16.64, and 22.05 cm respectively. In 4 flaps which were clinically used to repair defects, 3 flap completely survived, 1 flap had partial necrosis. Three patients were followed up 6 months, and the appearance and texture of the flap were satisfactory; 1 patient failed to be followed up.
  
  
  CONCLUSIONS
  Resecting the inferior costicartilage can prolong the pedicle of the rectus abdominis flap, therefore it can be used to repair defect on the upper chest and the neck.
authors: Jiaqi
authors: J
authors: Zhang
authors: Jinming
authors: J
authors: Zhang
authors: Weiqiang
authors: W
authors: Liang
authors: Chenyang
authors: C
authors: Ji
authors: Shujuan
authors: S
authors: Pan
authors: Yuhong
authors: Y
authors: Chen
authors: Shouquan
authors: S
authors: Gao
authors: Yuanyuan
authors: Y
authors: Yao
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000002:abnormalities / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D017568:Rectus Abdominis / Q000637:transplantation*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D013909:Thorax / Q000002:abnormalities / Q000637:transplantation*; D014945:Wound Healing