The trapezius perforator flap: Versatility for locoregional reconstruction

Frobert, P.; Bekara, Farid; Bertheuil, Nicolas; Delay, E.; Herlin, Christian; Chaput, Benoît

doi:10.1016/j.anplas.2018.06.001

Cited by 7 publications

(12 citation statements)

References 25 publications

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“…Although our patient ultimately did very well, there were some postoperative issues with distal flap perfusion. Flaps as large as 20 × 20 cm can be safely harvested from the dorsal scapular artery perforator, 4 and our skin paddle was well within this margin. However, our patient's contact dermatitis compromised our intraoperative visual assessment of flap perfusion, and on postoperative day 1, distal tip ischemia was evident.…”

Section: Resultsmentioning

confidence: 91%

“…Although described as "musclesparing," this approach nonetheless involves compromise of trapezius muscle overlying the pedicle. [4][5][6] We present a detailed technical description of our novel fasciocutaneous dorsal scapular artery perforator flap technique for spinal reconstruction that is completely muscle-sparing, which was very important to our patient who relies on his upper body for mobility and transfers.…”

Section: Introductionmentioning

confidence: 99%

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The Dorsal Scapular Artery Perforator Flap: A Complete Muscle-sparing Technique

Marr

Varga

Dumestre

2021

Plastic and Reconstructive Surgery - Global Open

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Summary: Cervical and thoracic spine reconstruction can be a difficult area to provide stable soft tissue coverage. Historically, trapezius myocutaneous flaps and trapezius muscle turnover flaps have proven to be reliable and versatile methods for the reconstruction of these areas. However, sequelae such as restriction of shoulder movement have been reported, as well as unsightly “humpback” contour deformities from turnover flap bulk. The use of the trapezius muscle for coverage has evolved to include descriptions of a trapezius perforator flap to address some of the issues of donor site morbidity, as it is described as a muscle-sparing technique. Although described as “muscle-sparing,” these approaches nonetheless involve sacrifice of trapezius muscle overlying the pedicle as that musculature is “deroofed” and divided off the pedicle during dissection. In this article, we present a detailed technical description of our novel technique to the trapezius perforator flap using a dorsal scapular artery flap for spinal reconstruction that is truly, completely muscle-sparing. This technique may prove useful for those patients in which even minimal disruption of trapezius muscle fibers is undesirable.

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Section: Resultsmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The Dorsal Scapular Artery Perforator Flap: A Complete Muscle-sparing Technique

Marr

Varga

Dumestre

2021

Plastic and Reconstructive Surgery - Global Open

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“…The perforator was dissected retrogradely to its source artery over a 5-cm distance, and no complications occurred postoperatively. Frobert et al 22 reported 3 cases using pedicled perforator flaps for resurfacing of the upper back, neck, and subclavicular fossa. The flap area was 16 × 8, 36 × 10, and 6 × 4 cm.…”

Section: Resultsmentioning

confidence: 99%

“…In 2006, Ogawa et al 3 summarized their clinical experiences of 41 superficial cervical artery trapezius flaps. The artery pedicled flap could be elevated with a very small amount of trapezius muscle, suggesting that it could be elevated as a “perforator flap.” Since then, there have been sporadic case reports of true SCAP flaps 21,22 . Despite these studies, information about the number and distribution of perforators over the course of the superficial cervical artery is still rather limited.…”

Section: Discussionmentioning

confidence: 99%

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Trapezius Perforator Flaps Based on Superficial Cervical Artery and Dorsal Scapular Artery

Wang

Li²,

et al. 2022

Ann Plast Surg

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Background: The flaps in the trapezius region are routinely elevated as musculocutaneous flaps. The anatomy of trapezius perforators and their clinical application are unclear. Methods: The number and distribution of superficial cervical artery perforators (SCAPs) and dorsal scapular artery perforators (DSAPs) were studied on 8 cadavers. The clinical usage of SCAP and DSAP flaps was investigated through a systematic literature review. Results: A total of 27 SCAPs and 28 DSAPs were found in the 16 hemibacks. The mean calibers of SCAP and DSAP were 0.9 ± 0.2 and 0.8 ± 0.2 mm, respectively. The vascular length to the takeoff of the source artery was 7.3 ± 2.0 cm (range, 4.7-9.7 cm) for SCAPs and was 8.1 ± 2.8 cm (range, 3.2-13.6 cm) for DSAPs. Contour and density heat maps showed that the SCAPs were clustered within approximately 3 to 5 cm above the horizontal line through the medial point of the scapular spine (x-axis) and 5 to 8 cm from the midline (y-axis, P = 0.001) and clustered DSAPs located in approximately 4 to 9 cm below the x-axis and 4 to 10 cm from the y-axis ( P = 0.002). Four SCAP and 19 DSAP flaps were found in literature. The mean sizes of SCAP flaps and DSAP flaps were 18.5 Â 7.8 and 16.5 Â 8.7 cm, respectively. Conclusions: Both SCAP and DSAP flaps can be elevated with a relatively long pedicle. The anatomical knowledge of the location of major clusters of perforators contributes to the application of these flaps.

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