Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.
Clin Anat. 2010 Jan;23(1):84-6. doi: 10.1002/ca.20877.
Ventral hernia formation is a common complication of rectus abdominis musculocutaneous flap harvest. The site and extent of harvest of the flap are known contributing factors. Therefore, an accurate location of the arcuate line of Douglas, which marks the lower extent of the posterior wall of the rectus sheath, may be relevant before harvesting the flap. This study is aimed at determining the position of the arcuate line in relation to anatomical landmarks of the anterior abdominal wall. Arcuate lines were examined in 80 (44 male, 36 female) subjects, aged between 18 and 70 years, during autopsies and dissection. The position of the arcuate line was determined in relation to the umbilicus, pubic symphysis, and intersections of rectus abdominis muscle. Sixty four (80.4%) cases had the arcuate line. In most cases (52), this line was located in the upper half of a line between the umbilicus and the pubic symphysis. Most males (93%) had the arcuate line, while more than a third of females did not have it. In all these cases, the line occurred bilaterally as a single arcade, constantly at the most distal intersection of the rectus abdominis muscle. Consequently, the arcuate line is most reliably marked superficially by the distal tendinous intersection of the rectus abdominis muscle. Harvesting of the muscle cranial to this point will minimize defects in the anterior abdominal wall that may lead to hernia formation.
腹侧疝的形成是腹直肌肌皮瓣采集的常见并发症。皮瓣采集的部位和范围是已知的促成因素。因此，在采集皮瓣之前，准确确定弓状线（Douglas 线）的位置可能很重要，该线标志着腹直肌鞘后壁的下限。本研究旨在确定弓状线相对于前腹壁解剖标志的位置。在 80 名（44 名男性，36 名女性）年龄在 18 至 70 岁之间的尸检和解剖中检查了弓状线。确定了弓状线相对于脐、耻骨联合和腹直肌交点的位置。64 例（80.4%）存在弓状线。在大多数情况下（52 例），这条线位于脐和耻骨联合之间的线的上半部分。大多数男性（93%）有弓状线，而超过三分之一的女性没有。在所有这些情况下，这条线都作为单一的拱廊双侧出现，始终位于腹直肌最远端的交点处。因此，弓状线最可靠的表面标志是腹直肌远端腱性交点。在此点之前采集肌肉将最大限度地减少可能导致疝形成的前腹壁缺陷。
