Arch Plast Surg.  2016 Nov;43(6):529-535. 10.5999/aps.2016.43.6.529.

The Trapezius Muscle Flap: A Viable Alternative for Posterior Scalp and Neck Reconstruction

Affiliations
  • 1Department of Anatomy, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
  • 2Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea. youngwooc@gmail.com
  • 3Department of Neurosurgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.

Abstract

BACKGROUND
The trapezius muscle flap is not usually the first reconstructive option for skin and soft tissue defects in the posterior neck and scalp due to surgeons' unfamiliarity with the surgical anatomy and developments in free tissue transfer techniques. The goals of this study were to describe the clinical use of trapezius flaps in posterior neck and scalp reconstruction, and to investigate the vascular anatomy of trapezius flaps in Asians in order to obtain information facilitating the safe design and elevation of flaps in which most of the muscle is preserved.
METHODS
A retrospective chart review was performed of 10 patients who underwent trapezius muscle flap for posterior neck and scalp defects. We also performed an anatomical study of 16 flaps harvested from 8 preserved Asian adult cadavers and evaluated the main landmarks relevant for trapezius muscle flap.
RESULTS
In the anatomical study, the mean vertical height from the inferior angle of the scapula to the point at which the superficial cervical artery penetrated the trapezius was 4.31±2.14 cm. The mean vertical height of the trapezius muscle flap pivot point was 9.53±2.08 cm from the external occipital protuberance. Among the 10 flaps, partial necrosis on the overlaid skin graft occurred in 1 patient and postoperative seroma occurred in another patient.
CONCLUSIONS
Vascular variations in the trapezius muscle flap are uncommon in Asians, but when present, such variations appear to have little impact on harvesting the flap or on its circulation. The trapezius muscle flap is a viable alternative for posterior neck and scalp reconstruction.

Keyword

Superficial back muscles; Surgical flap; Cadaver

MeSH Terms

Adult
Arteries
Asian Continental Ancestry Group
Cadaver
Humans
Neck*
Necrosis
Retrospective Studies
Scalp*
Scapula
Seroma
Skin
Superficial Back Muscles*
Surgical Flaps
Transplants
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