Lower Trapezius Myocutaneous Island Flap

Lower Trapezius Flap for Reconstruction of Posterior Scalp and Neck Defects after Complex Occipital-Cervical Surgeries

“…Early series before the recognition that the DSA is critical to flap survival in some patients suggested relatively high failure rates. 24,27 More recent reports, which acknowledge the potentially important contribution of the DSA, 26,28 have reported consistent success with the trapezius flap. The high rate of successful wound closure in this series of nine patients is likely due, at least in part, to preservation of the DSA and TSA in all nine cases.…”

“…To avoid some of the potential morbidity associated with free flaps, coverage with a regional pedicled flap is a potential option. The trapezius system has been described in the literature for coverage of numerous sites including oral cavity and oropharynx, 24 lateral face, 25 cervical spine, and posterior scalp. 26 The present series demonstrates that the lower trapezius flap (LTIMF or muscle-only variant) is a good choice for coverage of selected posterolateral scalp and neck defects that may develop after complex posterior occipital-cervical procedures.…”

Interpreting Lower Trapezius Musculocutaneous Flap Skin Paddle Perfusion with Indocyanine Green Angiography

“…Previous studies have shown an incidence of partial flap necrosis ranging from 2% to 57%. 1,[3][4][5]7,9 These prior studies offer a standardized flap design and harvest based on the angiosome concept and clinical experience. We suspect that utilizing a standard flap design and harvest in all patients will lead to some cases of partial flap necrosis.…”

Assessment of Fibula Flap Skin Perfusion in Patients Undergoing Oromandibular Reconstruction

“…Two large series that used pectoralis major myocutaneous flaps for head and neck reconstruction found that the rate of partial flap necrosis varied from 21% to 27% 4,5. For trapezius flaps, the risk of flap necrosis varied from 13% to 57% 6,7. The risk of partial necrosis of supraclavicular artery island flaps used for head and neck reconstruction has been reported to be as high as 18% 8.…”

“…4,5 For trapezius flaps, the risk of flap necrosis varied from 13% to 57%. 6,7 The risk of partial necrosis of supraclavicular artery island flaps used for head and neck reconstruction has been reported to be as high as 18%. 8 Large skin flaps with a random blood supply also have a considerable risk of partial flap necrosis.…”