Extended lower trapezius myocutaneous flap in burn scar reconstruction of the face and neck of children

Abstract

The extended lower trapezius myocutaneous flap is valuable in the management of burn reconstruction in the pediatric population.

Total cheek resurfacing with split ascending neck flap: A new approach

“…Several other flaps have been suggested for cheek reconstruction: pre-expanded supraclavicular artery flap [27]; expanded lower trapezius flap [28]; supraclavicular artery island flap [29,30]; supraclavicular prefabricated flap [31]; superficial cervical artery flap [32]; deltopectoral flap [33]; upper chest pedicled flap [34]; dorsal scapular flap [35]; shoulder flap [36]; flaps from chest wall [37]; cervicothoracic prefabricated flap, pedicled or island, regular or expanded [38]. Rarely free flaps were transferred: scapular, parascapular, deltopectoral, anterolateral thigh, and radial [39][40][41].…”

The Forgotten Flap: The Pedicled Trapezius Flap's Utility in Pediatric Head and Neck Reconstruction—A Systematic Review

“…Our results add to the existing pediatric literature (►Table 1), demonstrating favorable outcomes with regard to functional donor site morbidity. 15,[17][18][19][20][21][22][23][24][25] Age-related changes in muscle function and recruitment patterns may partially explain differences in functional outcomes between children and adults. In mid-adulthood, age-related decline in skeletal muscle mass occurs, especially of type II fibers, progressively leading to functional muscle loss and decreased strength.…”

“…52 Studies have described distal partial flap necrosis as the primary complication of the lower trapezius myocutaneous flap due to the relatively large surface area. 17,18 Although this is uncommon because of the dual blood supply to the flap, distal necrosis can be further minimized by meticulous dissection to avoid damaging the vascular network. 17,18 It is also important to acknowledge the increased risk of partial flap necrosis when utilizing the preexpanded extended lower trapezius flap, with rates ranging from 17 to 44% in studies of adults.…”

“…17,18 Although this is uncommon because of the dual blood supply to the flap, distal necrosis can be further minimized by meticulous dissection to avoid damaging the vascular network. 17,18 It is also important to acknowledge the increased risk of partial flap necrosis when utilizing the preexpanded extended lower trapezius flap, with rates ranging from 17 to 44% in studies of adults. 19,27 This particular flap design can be a useful tool in the reconstructive armamentarium, particularly when coverage of distant craniofacial defects is necessary.…”

“…2,15,16 While its utility has been well-described in adults, the scope of literature evaluating its application among the pediatric population is limited. 15,[17][18][19][20][21][22][23][24][25] Limited use is possibly due to apprehensions regarding potentially impaired upper extremity mobility, which has been reported in some adult studies. However, further investigation of the pedicled trapezius flap in pediatric H&N reconstruction is still warranted.…”