Trapezius perforator flaps: anatomical basis using 58 dissections

The trapezius muscle is a good option for soft tissue defects in the cervical and thoracic regions. However, pedicled flaps raised from perforators in the trapezius are rare. Through a series of cadaver dissections, the authors aim to map the perforating arteries in the trapezius muscle.

Dissection of 58 anatomical regions in 32 cadavers was carried out. The perforating arteries of the trapezius were inventoried based on their location, dimensions and frequency using the scapular spine and spinous process line as landmarks.

In 78% of cases, the main perforators of the trapezius were located along two vertical lines parallel to the spinous process line, 5-6 cm on either side of it, between the scapular spine laterally, the tip of the scapula caudally and the superior margin of the trapezius cranially. On each side of the spinous process line, we found an average of 16 perforators (range 5-27) with an average diameter of 0.6 mm (range 0.1-2.6 mm).

Our study shows that surgeons can use fixed landmarks when developing trapezius perforator flaps.