The anatomic basis of the transversus and rectus abdominis musculoperitoneal (TRAMP) composite flap

Summary The aim of this study was to provide an anatomic basis for the transversus and rectus abdominis musculoperitoneal (TRAMP) flap, recently successfully introduced for vulvovaginal reconstruction. In 25 cadavers the width and length of the portions of rectus and transversus abdominis muscles suitable for the TRAMP flap as well as the length and diameter of the inferior epigastric artery were assessed. The mean length of the rectus abdominis muscle was 32.42±0.48 cm and its width 6.15±0.12 cm. The suitable part of the transversus abdominis muscle measured 19.08±0.3 cm mean length with a mean width of 18.62±0.19 cm. No significant left-right differences were observed. The resulting area of the rectus abdominis muscle was 197.78±5.09 cm² and that of the transversus abdominis muscle 356.20±7.87 cm². The mean extramuscular course of the deep inferior epigastric artery (DIEA) was 4.97±0.09 cm with a mean diameter of 0.29±0.01 cm. This offers numerous possibilities for an anastomosis of the DIEA when the TRAMP flap is desired as a free flap. Because of its dimensions and flexibility the TRAMP offers several possibilities in reconstructive surgery.