Anatomical Location of the Tendinous Intersections of the Rectus Abdominis Muscle in Korean Women.

Suh, Hyun Suk; Eom, Jin Sub; Lee, Taik Jong

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2006;33(4):469-473.
Published online July 1, 2006.

Anatomical Location of the Tendinous Intersections of the Rectus Abdominis Muscle in Korean Women.

Hyun Suk Suh, Jin Sub Eom, Taik Jong Lee

Department of Plastic Surgery, University of Ulsan, College of Medicine, Seoul, Korea. tjlee@amc.seoul.kr

Abstract

PURPOSE
The transverse rectus abdominis myocutaneous(TRAM) flap has become a reliable method for autogenous breast reconstruction. However, dissection of the tendinous intersections of rectus abdominis is technically difficult. The tendinous intersection has significant vascularity within its fascial layers raising in importance of technique in elevation. If tendinous intersections are damaged during the elevation of the rectus muscle, circulation to TRAM flap can be endangered. The purpose of this study is to evaluate the number of tendinous intersections and to predict anatomical position of the tendinous intersections. METHODS: We dissected 182 consecutive TRAM flaps and measured the distance between xiphoid process and each tendinous intersection and evaluated the statistic correlation among the distance, patient's height and position of umbilicus.
RESULTS
In this study, in 30.7% of patients, two tendinous intersections were observed in one rectus abdominis muscle, in 67.7% three tendinous intersections, and in 1.6% four tendinous intersections, respectively. But there was no correlation between patient's height and the distance between xiphoid process and each tendinous intersection.
CONCLUSION
It still remains difficult to predict the position of tendinous intersections just by topography before the dissection. Careful and meticulous dissection of the tendinous intersections is still required.

Keywords: TRAM flap; Tendinous intersection