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Anatomical and Functional Recovery of Neurotized Remnant Rectus Abdominis Muscle in Muscle-Sparing Pedicled Transverse Rectus Abdominis Musculocutaneous Flap

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Author(s)
Woonhyeok JeongDaegu SonHyeonjung YeoHoijoon JeongJunhyung KimKihwan HanSoyoung Lee
Keimyung Author(s)
Son, Dae GuKim, Jun HyungHan, Ki HwanLee, So Young
Department
Dept. of Plastic Surgery (성형외과학)
Dept. of Rehabilitation Medicine (재활의학)
Journal Title
Archives of Plastic Surgery
Issued Date
2013
Volume
40
Issue
4
Abstract
Background

Pedicled transverse rectus abdominis musculocutaneous flaps typically sacrifice the entire muscle. In our experience, the lateral strip of the rectus abdominis muscle can be spared in an attempt to maintain function and reduce morbidity. When the intercostal nerves are injured, muscle atrophy appears with time. The severed intercostal nerve was reinserted into the remnant lateral strip of the rectus abdominis muscle to reduce muscle atrophy.


Methods

The authors retrospectively reviewed 9 neurotized cases and 10 non-neurotized cases. Abdominal computed tomography was performed to determine the area of the rectus muscles. Electromyography (EMG) was performed to check contractile function of the remnant muscle. A single investigator measured the mean areas of randomly selected locations (second lumbar spine) using ImageJ software in a series of 10 cross-sectional slices. We compared the Hounsfield unit (HU) pre- and postoperatively to evaluate regeneration quality.


Results

In the neurotization group, 7 of 9 cases maintained the mass of remnant muscle. However, in the non-neurotization group, 8 of 10 lost their mass. The number of totally atrophied muscles in each of the two groups was significantly different (P=0.027). All of the remnant muscles showed contractile function on EMG. The 9 remaining remnant rectus abdominis muscles showed declined the HU value after surgery but also within a normal range of muscle.


Conclusions

Neurotization was found to be effective in maintaining the mass of remnant muscle. Neurotized remnant muscle had contractile function on EMG and no fatty degeneration by HU value.






Keywords: Rectus abdominis; Nerve transfer; Electromyography; Multidetector computed tomography
Keimyung Author(s)(Kor)
손대구
김준형
한기환
이소영
Publisher
School of Medicine
Citation
Woonhyeok Jeong et al. (2013). Anatomical and Functional Recovery of Neurotized Remnant Rectus Abdominis Muscle in Muscle-Sparing Pedicled Transverse Rectus Abdominis Musculocutaneous Flap. Archives of Plastic Surgery, 40(4), 359–366. doi: 10.5999/aps.2013.40.4.359
Type
Article
ISSN
2234-6163
DOI
10.5999/aps.2013.40.4.359
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35092
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Plastic Surgery (성형외과학)
1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
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