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

한국 여성의 배곧은근에서 나눔힘줄(Tendinous Intersection)의 위치

  • Suh, Hyun Suk (Department of Plastic Surgery, University of Ulsan, College of Medicine) ;
  • Eom, Jin Sub (Department of Plastic Surgery, University of Ulsan, College of Medicine) ;
  • Lee, Taik Jong (Department of Plastic Surgery, University of Ulsan, College of Medicine)
  • 서현석 (울산대학교 의과대학 성형외과학교실) ;
  • 엄진섭 (울산대학교 의과대학 성형외과학교실) ;
  • 이택종 (울산대학교 의과대학 성형외과학교실)
  • Received : 2006.02.06
  • Published : 20060000

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

References

  1. Whetzel TP, Huang V: The vascular anatomy of the tendinous intersections of the rectus abdominis muscle. Plast Reconstr Surg 98: 83, 1996
  2. Kim DI, Lee UY, Han SH, Paik DJ, Koh KS, Chung RH, Lee PK, Rhie JW, Ahn ST: Morphologic Study of the Rectus Abdominis Muscle for Flap Surgery. Korean J Phys Anthropol 16: 137, 2003 https://doi.org/10.11637/kjpa.2003.16.3.137
  3. Boyd JB, Taylor GI, Corlett R: The vascular territories of the superior epigastric and the deep Inferior epigastric Systems. Plast Reconstr Surg 73: 1, 1984 https://doi.org/10.1097/00006534-198401000-00001
  4. Standring S: Gray's Anatomy: The anatomical basis of clinical practice. 39th ed, London Elsevier Churchill Livingstone, 2005, p 1105
  5. Kaufman T, Hurwitz DJ, Boehnke M, Futrell JW: The microcirculatory pattern of the transverse abdominal flap: A cross-sectional xerographic and CAT scanning study. Ann Plast Surg 14: 340, 1985 https://doi.org/10.1097/00000637-198504000-00007
  6. Hartrampf CR Jr, Michelow BJ: Anatomy of the anterior abdominal wall. In Hartrampf CR(eds): Breast reconstruction with living tissue. Norfolk, Hampton Press, 1991, p 3