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The blood supply to the lower rectus flap comes from the inferior epigastric vessels (right side shown), the last branch of the external iliac arteries. The epigastrics lie between transversalis fascia and anterior parietal peritoneum and penetrate the posterior surface of the lower third of the rectus muscle. The vessels ramify within the rectus and anastomose with branches of the superior epigastric, the continuation of the internal mammary artery (see TRAM flap).
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