Wonju City Public Health Center, Wonju-Si, Kangwondo 26417, Korea.
Department of Oral Biology, Division in Anatomy and Developmental Biology, Human Identification Research Institute, BK 21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
Toxins (Basel). 2021 Apr 9;13(4):269. doi: 10.3390/toxins13040269.
Breast reconstruction after mastectomy is commonly performed using transverse rectus abdominis myocutaneous (TRAM) flap. Previous studies have demonstrated that botulinum neurotoxin injections in TRAM flap surgeries lower the risk of necrosis and allow further expansion of arterial cross-sectional diameters. The study was designed to determine the ideal injection points for botulinum neurotoxin injection by exploring the arborization patterns of the intramuscular nerves of the rectus abdominis muscle. A modified Sihler's method was performed on 16 rectus abdominis muscle specimens. Arborization of the intramuscular nerves was determined based on the most prominent point of the xyphoid process to the pubic crest. All 16 rectus abdominis muscle specimens were divided into four muscle bellies by the tendinous portion. The arborized portions of the muscles were located on the 5-15%, 25-35%, 45-55%, and 70-80% sections of the 1st, 2nd, 3rd, and 4th muscle bellies, respectively. The tendinous portion was located at the 15-20%, 35-40%, 55-60%, and 90-100% sections. These results suggest that botulinum neurotoxin injections into the rectus abdominis muscles should be performed in specific sections.
乳房切除术后的乳房重建通常采用横行腹直肌肌皮瓣（TRAM）。先前的研究表明，TRAM 皮瓣手术中肉毒毒素注射降低了坏死的风险，并允许进一步扩大动脉横截面积。本研究旨在通过探索腹直肌肌内神经的分支模式来确定肉毒毒素注射的理想注射点。对 16 个腹直肌标本进行了改良的 Sihler 法。根据剑突至耻骨嵴的最突出点确定肌内神经的分支。所有 16 个腹直肌标本均通过腱部分为四个肌腹。肌肉的分支部分分别位于第一、第二、第三和第四肌腹的 5-15%、25-35%、45-55%和 70-80%节段。腱部位于 15-20%、35-40%、55-60%和 90-100%节段。这些结果表明，应在特定节段对腹直肌进行肉毒毒素注射。
