The "chimeric" trapezius muscle and fasciocutaneous flap (dorsal scapular artery perforator flap): a new design for complex 3-dimensional defects.

Abstract:

BACKGROUND:Multiple variations of the musculocutaneous trapezius flap have been described, each of which use a single composite musculocutaneous unit in their designs. The limitation of such designs is the ability to use the components in a 3-dimensional manner, with only 1 vector existing in the geometry of the musculocutaneous unit. METHODS:A review of the literature was undertaken with regard to designs of the musculocutaneous trapezius flap, and we present a new technique for flap design. With identification of individual perforators to each of the muscle and fasciocutaneous portions of the trapezius flap, the 2 components can act in a chimeric fashion, able to fill both a deep and complex 3-dimensional space while covering the wound with robust skin. RESULTS:A range of flap designs have been described, including transverse, oblique, and vertical skin paddles accompanying the trapezius muscle. We describe a technique with which a propeller-style skin paddle based on a cutaneous perforator can be raised in any orientation with respect to the underlying muscle. In a presented case, separation of the muscular and fasciocutaneous components of the trapezius flap was able to obliterate dead space around exposed cervicothoracic spinal metalwork and obtain robust wound closure in a patient with previous radiotherapy. CONCLUSIONS:This concomitant use of a muscle and fasciocutaneous perforator flap based on a single perforator, a so-called chimeric perforator flap, is a useful modification to trapezius musculocutaneous flap design.

journal_name

Ann Plast Surg

authors

Rozen WM,Fox CM,Leong J,Morsi A

doi

10.1097/SAP.0b013e31824e29a4

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

528-32

issue

5

eissn

0148-7043

issn

1536-3708

journal_volume

71

pub_type

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