ORAL AND MAXILLOFACIAL RECONSTRUCTION USING THE FREE RECTUS-ABDOMINISMYOCUTANEOUS FLAP - VARIOUS MODIFICATIONS FOR RECONSTRUCTION SITES

The rectus abdominis myocutaneous flap consists of the skin paddle, an terior rectus sheath, rectus muscle and deep inferior epigastric arter y and veins. Of these four components, the skin paddle, rectus sheath and rectus muscle could all be adjusted appropriately for reconstructi on sites. Only one or two large perforators in the paraumbilical regio n could easily supply the large abdominal wall. The bulkiness of the r ectus abdominis flap is reduced by removal of subcutaneous fat and rec tus muscle. These possibilities can provide many modification of the f lap for various reconstruction sites. 16 cases were reconstructed prim arily and secondarily using this flap after oral and maxillofacial tum or ablation. The results of these cases indicated a very favourable an d reliable vascularity. The rectus abdominis myocutaneous flap was con sidered to be one of the most suitable flaps for oral and maxillofacia l reconstruction. Various modifications for different reconstruction s ites are mainly discussed.