Experience with 33 epigastric rectus flaps in breast reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery

Background:

• The contralateral epigastric rectus flap (ERF) is a versatile myocutaneous island flap used in breast reconstruction.
• It incorporates epigastric skin and the superior rectus abdominis muscle, preserving the superior epigastric artery.

Purpose of the Study:

• To evaluate the epigastric rectus flap (ERF) as a reconstructive option in breast surgery.
• To compare the ERF with other flap options like the latissimus dorsi flap and the lower rectus flap.

Main Methods:

• The ERF is transferred on its vascular pedicle from the contralateral side to the mastectomized site.
• Donor site is concealed within the submammary fold, minimizing visible scarring.
• Surgical technique involves harvesting epigastric skin and a portion of the rectus abdominis muscle.

Main Results:

• The ERF provides a larger skin graft area compared to the latissimus flap, with skin quality comparable to breast skin.
• Advantages include no positional changes during surgery, preservation of muscle function, and an associated upper abdominal lift.
• The ERF is less suitable for patients with thin or irradiated skin and offers less adipose tissue than the lower rectus flap.

Conclusions:

• The ERF is a valuable technique for breast reconstruction, offering several benefits over the latissimus flap.
• It presents a less extensive procedure than the lower rectus flap with no abdominal scar.
• Patient selection is crucial, considering skin quality and the amount of adipose tissue required for optimal reconstruction.