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Related Experiment Videos

Rectus abdominis muscle innervation: implications for TRAM flap elevation

D C Hammond1, D L Larson, R N Severinac

  • 1Department of Plastic and Reconstructive Surgery, Grand Rapids Area Medical Education Center, Mich., USA.

Plastic and Reconstructive Surgery
|July 1, 1995
PubMed
Summary
This summary is machine-generated.

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This study mapped intercostal nerves in the rectus abdominis muscle, finding that partial muscle harvest can preserve innervation to specific muscle sections, crucial for TRAM flap breast reconstruction.

Area of Science:

  • Anatomy
  • Surgical Anatomy
  • Neuroanatomy

Background:

  • The rectus abdominis muscle is frequently used in reconstructive surgery, particularly TRAM flap breast reconstruction.
  • Understanding the precise innervation of the rectus abdominis muscle is critical for surgical techniques that aim to preserve muscle function.

Purpose of the Study:

  • To identify the anatomical course and location of intercostal nerves relative to the rectus abdominis muscle.
  • To assess the feasibility of preserving nerve supply to portions of the rectus abdominis muscle during partial harvest.

Main Methods:

  • Cadaver dissections of sixteen individuals to trace intercostal nerve pathways.
  • Histochemical staining of nerve biopsies to determine fiber content (sensory, motor, autonomic).
  • Electromyographic evaluation in five patients undergoing TRAM flap reconstruction with partial rectus abdominis muscle harvest.

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Main Results:

  • Six to eight intercostal nerves innervate the rectus abdominis, typically entering laterally and inferomedially.
  • Partial harvest of the medial two-thirds of the rectus abdominis muscle allowed preservation of innervation to the lateral third and the infra-umbilical portion.
  • Postoperative EMG confirmed retained innervation in the lateral strip (diminished function) and near-normal function in the infra-umbilical portion.

Conclusions:

  • Partial rectus abdominis muscle harvest techniques can potentially preserve innervation to specific muscle segments.
  • Preservation of the lateral and infra-umbilical portions of the rectus abdominis muscle may be achievable, impacting functional outcomes in reconstructive surgery.