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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2007 December;20(6):289-92
The trapezius vertical myocutaneous flap and head lesions
Fraccalvieri M., Verna G., Bocchiotti M. A., Ferrando P. M., Margara A., Bruschi S.
SCDU Chirurgia Plastica e Ricostruttiva ASO S. Giovanni Battista di Torino, Torino
During the last 5 years in our department 110 flaps have been used to cover head lesions after oncologic resection: 41 microsurgery flaps and 69 pedicled flaps.
The trapezius vertical myocutaneous flap has been used in 9 cases: 3 females and 6 males with a mean age of 58.7 years.
3 patients suffered of soft tissue defects of the occipital region of the head secondary to meningioma excision and associated RT, 2 presented soft tissue defects of the frontal-parietal region of the head for the same pathology previously mentioned; the remaining 4 patients had oropharyngeal defects due to oncologic demolition of adenocarcinomas of the mouth.
No complications have been reported and no flap failure occurred.
In conclusion, upon our experience and literature analysis, we can finally affirm that the flap based on trapezius muscle is versatile, reliable and thin. Providing a glabrous skin island with less subcutaneous tissue and therefore more pliability it is indicated in the treatment of medium dimension, deep and complex soft tissue defects especially of the head and neck region.
The only absolute contraindication consists in former surgical procedures involving the transverse cervical artery or its origin which is considered most frequently the main pedicle of the flap.
To be mentioned as disadvantages are the unaesthetic dorsal scar and the need to harvest the all muscle in order to assure its complete mobility which produces a functional disability in the upper limb elevation.