*Kazuki Hasegawa,
**Masashi Yamashiro

*Head oF department of orail and maxillofacial surgery; shizuoka city hospital, shizuoka city, shizuoka prefecture japan
**Head of depARtMent oF oRAl And MAxilloFAciAl SuRgeRy; gunMA pReFectuRAl cAnceR centeR; gunMA pReFectuRe; JApAn

The rectus abdominis flap (rectus abdominis myocutaneous flap) is oneof the most popular flap for soft tissue reconstruction of the head andneck regions in Japan.
One hundred twenty-seven patients underwent oral and maxillofacial reconstruction using recutus abdominis flap at the department of maxillofacial surgery, Tokyo Medical and Dental University in Tokyo and Department of Oral and Maxillofacial Surgery, Shizuoka City Hospital in Shizuoka City. There were a little postoperative complications including 2 total necroses, 5 infections, and 3 wound dehiscence. Partial necrosis was observed only in the superficial layer of very small part of skin paddle of 5 cases. They were not related with wound dehiscence and infection.
This flap has many advantages, as follows; 1) The nutrient pedicle is anatomically stable with adequate length and size for anastomosis, 2) The large skin paddle with very rich vascularity can be harvested, 3) The flap can be variously modified for reconstruction sites. 4) Two teams can perform tumor ablation and harvesting flap at the same time. 5) The donor site morbidity is very low. The principles on this flap including surgical anatomy, technique to elevate the flap, various modifications for reconstruction sites, indication and contraindication, and clinical cases, were introduced.

Key words: Oral and maxillofacial reconstruction, rectus abdominis flap, oral carcinoma