ABSTRACT
The rectus abdominis free flap is a versatile myocutaneous flap based upon the deep inferior epigastric artery and its associated vena comitans. The flap has been well described for its use in reconstruction of large volume defects of the head and neck. Advantages of the flap include ease of harvest, two-team approach and a long vascular pedicle with a large vessel diameter. The flap can also be harvested based solely upon the perforating vessels traversing the rectus muscle within the periumbilical region. The deep inferior epigastric muscle-sparing perforator (DIEP) flap variant has continued to increase in popularity due to its decreased risk of abdominal wall herniation, bulge and post-operative pain. The rectus abdominis free flap still proves to be a valuable reconstructive tool and should be considered especially in situations requiring large amounts of soft tissue to be transferred. This chapter discusses both the rectus abdominis myocutaneous free flap and the DIEP flap for use in head and neck reconstruction.
