Paraspinous Muscle Flaps

Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

“…The flap coverage is the standard treatment of infected wounds after spine surgery [9,14,15,27,32,41,45,46,63,66]. The use of omental transposition in the treatment of recurrent sarcoma of the back was also described [38].…”

Muscle Flap Salvage of Spine Wounds With Soft Tissue Defects or Infection

“…A few reports of flap coverage of the spine have been published. 1,2,4,12 The current series is distinguished by the large size of the wounds, averaging 10 vertebral bodies in length. By the authors' calculations, all the series referenced in this report had an average wound length of three to five vertebral bodies.…”

Paraspinous muscle flap for the treatment of an empyema cavity: three case reports

“…Manstein et al [12] discussed their successful experience treating 12 consecutive patients with paraspinous muscle flaps for difficult spinal wounds and reviewed the anatomy of the musculature of the spinous processes. The paraspinous muscle flap is an excellent choice for wound reconstruction because it provides many advantages including: (1) its volume is maintained even if patients are suffering from malnutrition [13]; (2) it is appropriate for the posterior pleural cavity where abscess pooling usually occurs due to gravity; (3) volume adjustment is easy due to the long and narrow shape; (4) it can be harvested superiorly or inferiorly at any paraspinal height in the longitudinal direction; (5) dissecting and elevating the flap is easy and less invasive; (6) the muscles are bilateral, so bilateral flaps can be utilized [12]; and (7) it has a constant vascular supply [13].…”

“…The paraspinous muscle flap is an excellent choice for wound reconstruction because it provides many advantages including: (1) its volume is maintained even if patients are suffering from malnutrition [13]; (2) it is appropriate for the posterior pleural cavity where abscess pooling usually occurs due to gravity; (3) volume adjustment is easy due to the long and narrow shape; (4) it can be harvested superiorly or inferiorly at any paraspinal height in the longitudinal direction; (5) dissecting and elevating the flap is easy and less invasive; (6) the muscles are bilateral, so bilateral flaps can be utilized [12]; and (7) it has a constant vascular supply [13]. However, it also has a few disadvantages, including: (1) the coverage area is limited within the posterior region because the arc of rotation is limited [13]; (2) little is known about the long-term effects and whether the unilateral use of extended flaps causes postural problems, e.g., scoliosis [12]. Therefore, it is important to firmly keep in mind that this muscle plays only a supportive role as a plombage material.…”

“…Muscles that have been used include the latissimus dorsi, trapezius, intercostal, and scapular muscles, chosen based on the size and location of the empyema cavity [1][2][3][4][5]. The filling of dead space with muscle is preferable because it provides volume and coverage [4,[6][7][8]. However, these volumes are decreased in patients suffering from malnutrition; and flap dissection and elevation are sometimes invasive.…”