Clinical anatomy and application of the free inferior epigastric artery transverse rectus abdominis myocutaneous flap

Objective: To improve the techniques of harvesting the free inferior epigastric artery transverse rectus abdominis myocutaneous(TRAM) flap on the basis of the anatomic studies.Methods: We performed breast reconstruction for four patients after mastectomy with this deep inferior epigastric perforator(DIEP) flap,sparing the whole rectus abdominis muscle,and preserving adequate abdominal wall competence.We also reviewed related literature and discussed its advantages.Results: This flap had all the advantages inherent in TRAM flap breast reconstruction and the donor site morbidities were avoided.The variety of the dimension and thickness of the flap and the length of its pedicle increased its flexibility in clinical application.Conclusions: DIEP flap can repair various defects as required.As it spares the whole rectus abdominis muscle,it has minimal insult to the abdominal wall and has the effect of abdominoplasty for middle-aged women.The application of this kind of flap represent the direction of plastic surgery's development.