The purpose of this study was to define the arterial vascular anatomy of the tendinous intersections of the rectus abdominis muscle through anatomic dissection and perforator mapping. In 14 fresh cadavers, the deep inferior epigastric arteries were injected with blue latex. In 7 specimens (14 rectus abdominis muscles), dissection of each tendinous intersection was performed under loupe magnification. In the other 7 specimens (10 rectus abdominis muscles), perforator mapping was performed at each intersection relative to the rest of the rectus abdominis muscle. In 2 additional cadavers, radiographs were taken of barium-latex-injected specimens. We found that the vascular architecture of the intersections is characterized by transverse arcades arising from either the superior or inferior epigastric arteries, which send branches supplying muscle or the overlying skin. There is a higher number of perforators per square centimeter originating in the intersections than in the rest of the rectus abdominis muscle. To obtain optimal vascular supply, the design of transverse rectus abdominis flaps may be based on intersection location as well as paraumbilical location.
From the Division of Plastic Surgery at the University of California, Davis Medical Center. Received for publication November 9, 1994; revised June 19, 1995.
Presented at the Senior Residents' Plastic Surgery Conference, in Boston, Massachusetts, in May of 1994, and at the California Society of Plastic Surgeons Annual Meeting, in Napa, California, in May of 1995.
Thomas P. Whetzel, M.D.
Division of Plastic Surgery University of California, Davis, Medical Center 4301 X Street, Suite 2430 Sacramento, Calif. 95817