What is the role of the rectus muscles in TRAM breast reconstruction?

Updated: Jul 28, 2021
  • Author: Michael R Zenn, MD, MBA, FACS; Chief Editor: James Neal Long, MD, FACS  more...
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The entire rectus muscle may be included or the muscle may be split; either way, muscles are denervated and muscle function is impaired when 2 pedicles are used. Splitting the muscle is more time consuming and potentially hazardous to the blood supply of the flap. Some surgeons believe that splitting the muscle helps closure of the abdomen.

Rectus muscles are divided from their pubic insertion, allowing the flap to be rotated superiorly through a tunnel to the mastectomy site. Superior epigastric vessels are spared, as they provide blood supply to the transferred tissue.

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