ABSTRACT
The rectus abdominis free flap is a versatile myocutaneous flap based on the deep inferior epigastric artery and its associated venae comitantes. The flap was first described by Drever in 1977 as the ‘epigastric island flap’, and later adapted for breast reconstruction. The rectus abdominis muscle is a strap-like vertical muscle, approximately 30 cm in length by 6 cm in width, originating from the symphysis pubis and inserts into the 5th, 6th and 7th costal cartilage along with the xiphoid process. The muscle is enveloped by a tough rectus sheath, formed by the fascia of the three abdominal wall muscles originating at the linea semilunaris. The dual vascular supply to the rectus abdominis muscle is based on the deep superior and inferior epigastric arteries. After noting the appropriate landmarks and designing the skin paddle, the skin and subcutaneous tissue are incised and dissected from the lateral aspect until the fascia overlying the external oblique muscle is encountered.
