An anatomic study for the rectus abdominis myocutaneous flap combined with a vascularized rib.

The anatomy of the vascular connections between the eighth intercostal vessels and the deep epigastric vessels was studied in a series of 20 dissections in 10 preserved cadavers to develop the rectus abdominis myocutaneous flap combined with a vascularized rib. The distance between the point where the eighth intercostal vessels attached to the costal margin and the xiphoid process and the arcuate line, which become a good guide for design of the flap, was measured. The average length of the vascular pedicle of a vascularized rib was over 10 cm. Possible clinical uses of this compound flap for reconstruction of a composite maxillary or mandibular defect are described.