Microvascular reconstruction of the upper extremity with the rectus abdominis muscle.

Large soft-tissue defects of the upper extremity are difficult to reconstruct. Defects in 21 patients (15-75 years old) were treated by free tissue transfer of the rectus abdominis muscle. The defects were the result of trauma or resection of tumor and measured more than 15 x 15 cm. The muscle was transferred on the inferior epigastric pedicle and covered with a skin graft within 48 hours. All transfers were successful, and early soft-tissue healing occurred. This procedure offers the advantages of easy positioning, large donor vessels, and a highly vascular soft tissue reconstruction. The long-term functional and cosmetic results have been excellent.