Microsurgical transfer of the rectus abdominis muscle using the superior epigastric vessels

A microsurgical transplant of the rectus abdominis muscle based on its superior pedicle is described. This procedure represents a salvage maneuver used in a patient in whom the inferior pedicle was found to have been previously injured. Vessels of adequate caliber and a pedicle of sufficient length were found by dissecting the superior epigastric pedicle to the level of the costal margin. In cases in which rectus flap harvest is complicated by a damaged deep inferior epigastric pedicle, we recommend exploration of the superior pedicle before abandoning the flap.