Ultrasonographic Evaluation of the Rectus Abdominis Muscle After Breast Reconstruction With the DIEP Flap

2005 ◽  
Vol 54 (5) ◽  
pp. 483-486 ◽  
Author(s):  
Kim Alexander T??nseth ◽  
Anne G??nther ◽  
Knut Brabrand ◽  
Ingemar Fogdestam ◽  
Bj??rn Mikael Hokland
2021 ◽  
Vol 10 (1) ◽  
pp. 63-67
Author(s):  
A. V. Chernykh ◽  
M. P. Popova ◽  
V. Yu. Brigadirova ◽  
L. A. Rusakova

Currently, the most optimal option for breast reconstruction after mastectomy is the use of a pedicle DIEP flap from the inferior epigastric artery.The aim of the study was to study the features of the typical and variant anatomy of the inferior epigastric artery in women in the applied aspect.Material and methods. The study was carried out on 20 unfixed female bodies who died at the age of 54.6±4.7 years. We studied the level of intersection of the main trunk of the inferior epigastric artery with the lateral edge of the rectus abdominis muscle, the distance from this artery to the midline at different measurement levels, as well as the outer diameter of the studied vessel.Results. On the right, at different measurement levels, the distance from the main trunk of the inferior epigastric artery to the midline, the diameter of the artery, as well as the level of its intersection with the lateral edge of the rectus abdominis muscle in relation to the upper edge of the pubic bone, significantly exceed those on the left.Conclusion. It is necessary to take into account the peculiarities of the topographic anatomy of the inferior epigastric artery, planning and carrying out breast reconstruction with a DIEP flap, in order to prevent the development of necrosis in the postoperative period. For better reperfusion of the reconstruction area in the postoperative period, it is preferable to cut out the flap with the isolation of the right inferior epigastric artery (due to its larger diameter).


Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 269
Author(s):  
Kyu-Ho Yi ◽  
Hyung-Jin Lee ◽  
Ji-Hyun Lee ◽  
Kyle K. Seo ◽  
Hee-Jin Kim

Breast reconstruction after mastectomy is commonly performed using transverse rectus abdominis myocutaneous (TRAM) flap. Previous studies have demonstrated that botulinum neurotoxin injections in TRAM flap surgeries lower the risk of necrosis and allow further expansion of arterial cross-sectional diameters. The study was designed to determine the ideal injection points for botulinum neurotoxin injection by exploring the arborization patterns of the intramuscular nerves of the rectus abdominis muscle. A modified Sihler’s method was performed on 16 rectus abdominis muscle specimens. Arborization of the intramuscular nerves was determined based on the most prominent point of the xyphoid process to the pubic crest. All 16 rectus abdominis muscle specimens were divided into four muscle bellies by the tendinous portion. The arborized portions of the muscles were located on the 5–15%, 25–35%, 45–55%, and 70–80% sections of the 1st, 2nd, 3rd, and 4th muscle bellies, respectively. The tendinous portion was located at the 15–20%, 35–40%, 55–60%, and 90–100% sections. These results suggest that botulinum neurotoxin injections into the rectus abdominis muscles should be performed in specific sections.


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