Plastic and Reconstructive Surgery

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Plastic & Reconstructive Surgery:
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"Components Separation" Method for Closure of Abdominal-Wall Defects: An Anatomic and Clinical Study.

Ramirez, Oscar M. M.D.; Ruas, Ernesto M.D.; Dellon, A. Lee M.D.

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Closure of large abdominal-wall defects usually requires the transposition of remote myocutaneous flaps or free-tissue transfers. The purpose of this study was to determine if separation of the muscle components of the abdominal wall would allow mobilization of each unit over a greater distance than possible by mobilization of the entire abdominal wall as a block.

The abdominal walls of 10 fresh cadavers were dissected. This demonstrated that the external oblique muscle can be separated from the internal oblique in a relatively avascular plane. The rectus muscle with its overlying rectus fascia can be elevated from the posterior rectus sheath. The compound flap of the rectus muscle, with its attached internal oblique-transversus abdominis muscle, can be advanced 10 cm around the waistline. The external oblique has limited advancement. These

(C)1990American Society of Plastic Surgeons


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