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Epigastric and Rectus Abdominis Flap


- Discussion:
    - inferior epigastric pedicle is long (8 to 10 cm) and reliable;
    - muscle width of 8 to 10 cm is limited, and the skin paddle is long & bulky when compared to the Latissimus Dorsi;
    - rectus abdominis muscle can be harvested thru either a transverse or paramedian approach;
    - muscle is divided superiorly and reflected inferiorly along plane of posterior rectus fascia;
    - peritoneal perforator in the periumbilical region should be identified and ligated before division;
    - major pedicle is found by reflecting the anterior rectus fascia laterally, & by reflecting anterior rectus fascia laterally, & by skeletonizing the vessels in caudal fashion to external iliac artery and veins


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