The trapezius myocutaneous flap. Dependability and limitations.

Area of Science:

• Plastic Surgery
• Head and Neck Reconstruction
• Surgical Anatomy

Background:

• Trapezius myocutaneous flaps are utilized for head and neck defect reconstruction.
• Previous reports often focus on a single flap variation.

Purpose of the Study:

• To detail three distinct trapezius myocutaneous flap types: superior, lateral island, and extended island.
• To analyze the reconstructive applications and complication rates of these flaps.
• To discuss the vascular supply of the trapezius muscle, emphasizing arterial variability.

Main Methods:

• Retrospective review of 56 trapezius myocutaneous flaps (28 superior, 24 lateral island, 4 extended island) in 55 patients.
• Analysis of flap success, complications, and limitations.
• Discussion of transverse cervical and dorsal scapular artery variations.

Main Results:

• Major complications occurred in 2/28 superior, 5/24 lateral island, and 1/4 extended island flaps.
• Superior flaps are dependable but have limited application.
• Lateral and extended island flaps offer broader use but can be affected by prior surgery, malignancy, or vascular variability.
• 30% of lateral island flap attempts were aborted due to limitations.

Conclusions:

• Trapezius myocutaneous flaps are valuable for specific head and neck reconstructions.
• Flap selection depends on defect size, location, and patient factors.
• Understanding vascular anatomy is crucial for successful flap utilization.