Objective    To investigate The anatomical basis and therapeutic effects of repairing with musculocutaneous fiap for rectus abdominis in medium incisional hernia belonging to the middle or large types. Methods　(1)The medium incisional hernia cases of middle and large types were 48, whose ages were between 20 to 67 and who had received the repair with patch; 29 middle types were divided into 17 males and 12 females,and 23 large types were divided into 13 males and and 7 females (2)Compared with another 52 cases with medium incisional hernia cases of middle and large types in the same time ,whose ages were between 23 to 65 and who had taken the repair with abdominal tissue ; 28 middle types were divided inot 18 males and 10females; 20 large types were divided into 13 males and 10 females.　Result　The repair with composite skin flap rectus compared with those repaired with patch:(1)the recurrence rate, middle-type incisional hernia group, the observation group was 7.1％ and the control group was 3.4%, P>0.05;in large-type incisional hernia group, the observation group was 15.0％ and the control group was 4.3%,P>0.05.(2)Foreign body sensation and chronic pain after operation, the rate, in middle-type incisional hernia group,the observation type were 0% and 0.7％ and the control group were 41.3%and 95.7%,  P<0.05;in large-sized incisional hernia group,the observation group were 0% and 30％ and the control group were 34.5% and 47.8%,P<0.05.　Conclusions　The repair in medium incisional hernia of middle to large types with composite rectus musculocutaneous flaps has the same efficacy with the tension-free herniorrhaphy.,but has obviously superiority when it comes to complications and discomfort.