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. 2022 Nov 1;89(5):502-509.
doi: 10.1097/SAP.0000000000003288. Epub 2022 Sep 9.

Lower Trapezius Myocutaneous Propeller Flap Based on Dorsal Scapular Artery

Miao Wang  1 , Mengqing Zang, Shan Zhu, Shanshan Li, Tinglu Han, Zixiang Chen, Yuanbo Liu
Affiliations

Lower Trapezius Myocutaneous Propeller Flap Based on Dorsal Scapular Artery

Miao Wang et al. Ann Plast Surg. .

Abstract

Background: The pedicled lower trapezius myocutaneous flap is generally transferred to the recipient site through a subcutaneous tunnel, and a portion of the flap buried in the tunnel needs to be de-epithelialized. Thus, considerable amount of normal skin is sacrificed, and the redundant tissue buried in the tunnel can cause bulging deformity. We believe that transferring the lower trapezius myocutaneous flap in a propeller fashion can avoid the aforementioned issues.

Methods: A retrospective review was performed on all lower trapezius myocutaneous propeller flap reconstructions by a single surgeon from July 2013 to March 2021. Data on patient demographics, diagnosis, features of the defect, characteristics of the flap, and the outcome were collected and analyzed.

Results: Thirty-three lower trapezius myocutaneous propeller flaps were used to reconstruct soft tissue defects in the head, neck, and back. The etiologies were malignancy, trauma, postburn scar contracture, and congenital melanocytic nevus. The mean skin paddle dimensions were 29.0 cm in length (range, 13-45 cm) and 10.9 cm in width (range, 6-15 cm). The donor sites were closed primarily in 30 patients, closed using a skin graft in 1 patient, and covered with the second flap in 2 patients. Venous congestion occurred in the distal portion of 4 flaps and partial necrosis in the distal 6 cm of 1 flap. The average follow-up time was 17.5 months (range, 1-56 months). The normal contour of the back was preserved without bulging deformity. No patient developed a winged scapula or a decrease in shoulder elevation.

Conclusions: The lower trapezius myocutaneous propeller flap may be an option for reconstruction of soft tissue defects of the head, neck, and back with less waste of normal tissue and bulging deformity.

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Conflict of interest statement

Conflicts of interest and sources of funding: The authors received financial support for this research from the Hospital Foundation of Plastic Surgery Hospital, Chinese Academy of Medical Sciences (YS202017).

References

    1. Baek SM, Biller HF, Krespi YP, et al. The lower trapezius island myocutaneous flap. Ann Plast Surg . 1980;5:108–114.
    1. Sadigh PL, Chang LR, Hsieh CH, et al. The trapezius perforator flap: an underused but versatile option in the reconstruction of local and distant soft-tissue defects. Plast Reconstr Surg . 2014;134:449e–456e.
    1. Hafezi F, Naghibzadeh B, Pegahmehr M, et al. Extended vertical trapezius fasciocutaneous flap (back flap) in face and neck burn scar reconstruction. Ann Plast Surg . 2008;61:441–446.
    1. Chen WL, Wang Y, Zhou B, et al. Comparison of the reconstruction of through-and-through cheek defects involving the labial commissure following tumor resection using four types of local and pedicle flaps. Head Face Med . 2019;15:12.
    1. Kim SY, Lee KT, Mun GH. Reliable harvest of a dorsal scapular artery perforator flap by augmenting its perfusion. Microsurgery . 2016;36:152–156.

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