Application of Botulinum Neurotoxin Injections in TRAM Flap for Breast Reconstruction: Intramuscular Neural Arborization of the Rectus Abdominis Muscle
Autor: | Hyung-Jin Lee, Ji-Hyun Lee, Hee Jin Kim, Kyu-Ho Yi, Kyle K. Seo |
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Rok vydání: | 2021 |
Předmět: |
Male
Botulinum Toxins Health Toxicology and Mutagenesis Mammaplasty Rectus Abdominis lcsh:Medicine 030230 surgery Toxicology Injections Intramuscular Article rectus abdominis muscle 03 medical and health sciences 0302 clinical medicine medicine Cadaver Humans Pubic crest Rectus abdominis muscle Mastectomy Aged Aged 80 and over Neuronal Plasticity business.industry lcsh:R botulinum neurotoxin Anatomy Middle Aged Myocutaneous Flap Botulinum neurotoxin Tram flap medicine.anatomical_structure Neuromuscular Agents Female Breast reconstruction business 030217 neurology & neurosurgery Sihler’s method |
Zdroj: | Toxins, Vol 13, Iss 269, p 269 (2021) Toxins Volume 13 Issue 4 |
ISSN: | 2072-6651 |
Popis: | 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. |
Databáze: | OpenAIRE |
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