Mathes & Bostwick (1977) surgically manipulated the rectus
abdominis myocutaneous flap to repair defects in the
anterior abdominal wall. Subsequently this flap was used in
breast reconstruction (Robbins, 1981; Hartrampf et al.
1982) as a donor for free-tissue transfer (Bunkis et al. 1983)
and to repair defects in the groin (Logan & Mathes, 1984;
Ramasastry et al. 1989). Disadvantages of this flap are that
it can be too thick to use effectively and a direct abdominal
hernia may occur through the inguinal triangle (Mathes &
Bostwick, 1977; Pennington & Pelly, 1980; Ramasastry et
al. 1989; Itoh & Arai, 1993). To overcome these disadvantages the rectus
abdominis and the fascia covering the
inguinal triangle must be intact. Surgeons therefore harvested
the inferior epigastric skin flap for free-tissue skin transfer;
this flap contained little or no rectus abdominis muscle or
transversalis fascia (Koshima & Soeda, 1989). Previous
investigators determined the anatomical basis for the use of
this skin flap and used it to repair defects following resection
of ulcers and scar tissue on the head, neck and extremities
(Itoh & Arai, 1993).