[Use of superior musculus rectus abdominis flap in the reconstruction of the thoracic wall]. / L'impiego del T.R.A.M. Superiore nella ricostruzione della parete toracica.

The paper reports the Author's experience of the use of the muscle-skin flap of the upper rectum homolateral to the abdomen in the reconstruction of defects of the anterior thoracic wall following cancer surgery or radionecrosis, and compares it to that using other flaps (lower T.R.A.M., Latissimus dorsi, etc.). The well known anatomy of the flap, which is fed by the upper epigastric artery, also requires a precise surgical technique to isolate the muscular fibres without damaging vascularisation, a fundamental requisite for the vitality of the flap itself. Equally important for the vitality of the operation is a detailed study of the skin above the flap in patients treated with radiotherapy. The common and specific (epigastric hernia) complications of this operation are also examined, together with the precautions used by the Authors to prevent their occurrence.