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Published in: Surgical and Radiologic Anatomy 8/2018

01-08-2018 | Original Article

Trapezius perforator flaps: anatomical basis using 58 dissections

Authors: Philippe Manyacka Ma Nyemb, Christian Fontaine, Véronique Martinot-Duquennoy, Xavier Demondion, Jean-Marc Ndoye

Published in: Surgical and Radiologic Anatomy | Issue 8/2018

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Abstract

Introduction

The trapezius muscle is a good option for soft tissue defects in the cervical and thoracic regions. However, pedicled flaps raised from perforators in the trapezius are rare. Through a series of cadaver dissections, the authors aim to map the perforating arteries in the trapezius muscle.

Materials and methods

Dissection of 58 anatomical regions in 32 cadavers was carried out. The perforating arteries of the trapezius were inventoried based on their location, dimensions and frequency using the scapular spine and spinous process line as landmarks.

Results

In 78% of cases, the main perforators of the trapezius were located along two vertical lines parallel to the spinous process line, 5–6 cm on either side of it, between the scapular spine laterally, the tip of the scapula caudally and the superior margin of the trapezius cranially. On each side of the spinous process line, we found an average of 16 perforators (range 5–27) with an average diameter of 0.6 mm (range 0.1–2.6 mm).

Conclusion

Our study shows that surgeons can use fixed landmarks when developing trapezius perforator flaps.
Literature
1.
go back to reference Angrigiani C, Grilli D, Karanas YL, Longaker MT, Sharma S (2003) The dorsal scapular island flap: an alternative for head, neck, and chest reconstruction. Plast Reconstr Surg 111(1):67–78CrossRefPubMed Angrigiani C, Grilli D, Karanas YL, Longaker MT, Sharma S (2003) The dorsal scapular island flap: an alternative for head, neck, and chest reconstruction. Plast Reconstr Surg 111(1):67–78CrossRefPubMed
2.
go back to reference Baek SM, Biller HF, Krespi YP, Lawson W (1980) The lower trapezius island myocutaneous flap. Ann Plast Surg 5(2):108–114CrossRefPubMed Baek SM, Biller HF, Krespi YP, Lawson W (1980) The lower trapezius island myocutaneous flap. Ann Plast Surg 5(2):108–114CrossRefPubMed
3.
go back to reference Blondeel PN, Morris SF, Hallock GG, Neligan PC (2013) Perforator flaps: anatomy, technique, clinical applications. CRC Press, Boca Raton Blondeel PN, Morris SF, Hallock GG, Neligan PC (2013) Perforator flaps: anatomy, technique, clinical applications. CRC Press, Boca Raton
4.
go back to reference Boucher F, Mojallal A (2015) Atlas des artères perforantes de la peau, du tronc et des membres. Elsevier Masson, Paris Boucher F, Mojallal A (2015) Atlas des artères perforantes de la peau, du tronc et des membres. Elsevier Masson, Paris
5.
go back to reference Haas F, Weiglein A, Schwarzl F, Scharnagl E (2004) The lower trapezius musculocutaneous flap from pedicled to free flap: anatomical basis and clinical applications based on the dorsal scapular artery. Plast Reconstr Surg 113(6):1580–1590CrossRefPubMed Haas F, Weiglein A, Schwarzl F, Scharnagl E (2004) The lower trapezius musculocutaneous flap from pedicled to free flap: anatomical basis and clinical applications based on the dorsal scapular artery. Plast Reconstr Surg 113(6):1580–1590CrossRefPubMed
6.
go back to reference Hafezi F, Naghibzadeh B, Pegahmehr M, Boddouhi N, Nouhi A (2008) Extended vertical trapezius fasciocutaneous flap (back flap) in face and neck burn scar reconstruction. Ann Plast Surg 61(4):441–446CrossRefPubMed Hafezi F, Naghibzadeh B, Pegahmehr M, Boddouhi N, Nouhi A (2008) Extended vertical trapezius fasciocutaneous flap (back flap) in face and neck burn scar reconstruction. Ann Plast Surg 61(4):441–446CrossRefPubMed
7.
go back to reference Hamdi M, Stillaert FB (2010) Pedicled perforator flaps in the trunk. Clin Plast Surg 37(4):655–665CrossRefPubMed Hamdi M, Stillaert FB (2010) Pedicled perforator flaps in the trunk. Clin Plast Surg 37(4):655–665CrossRefPubMed
8.
go back to reference Ikka L, Mihalea C, Achour NB, Khalek HA, Vacher C (2016) The origin of the dorsal scapular artery: anatomic variations and surgical applications. Surg Radiol Anat 38(9):1–7CrossRef Ikka L, Mihalea C, Achour NB, Khalek HA, Vacher C (2016) The origin of the dorsal scapular artery: anatomic variations and surgical applications. Surg Radiol Anat 38(9):1–7CrossRef
9.
go back to reference Lynch JR, Hansen JE, Chaffoo R, Seyfer AE (2002) The lower trapezius musculocutaneous flap revisited: versatile coverage for complicated wounds to the posterior cervical and occipital regions based on the deep branch of the transverse cervical artery. Plast Reconstr Surg 109(2):444–450CrossRefPubMed Lynch JR, Hansen JE, Chaffoo R, Seyfer AE (2002) The lower trapezius musculocutaneous flap revisited: versatile coverage for complicated wounds to the posterior cervical and occipital regions based on the deep branch of the transverse cervical artery. Plast Reconstr Surg 109(2):444–450CrossRefPubMed
10.
go back to reference Maruyama Y, Nakajima H, Fujino T, Koda E (1981) The definition of cutaneous vascular territories over the back using selective angiography and the intra-arterial injection of prostaglandin E1: some observations on the use of the lower trapezius myocutaneous flap. Brit J Plast Surg 34(2):157–161CrossRefPubMed Maruyama Y, Nakajima H, Fujino T, Koda E (1981) The definition of cutaneous vascular territories over the back using selective angiography and the intra-arterial injection of prostaglandin E1: some observations on the use of the lower trapezius myocutaneous flap. Brit J Plast Surg 34(2):157–161CrossRefPubMed
11.
go back to reference Mathes SJ, Nahai F (1981) Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg 67(2):177–187CrossRefPubMed Mathes SJ, Nahai F (1981) Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg 67(2):177–187CrossRefPubMed
12.
go back to reference Morris SF, Tang M, Almutari K, Geddes C, Yang D (2010) The anatomic basis of perforator flaps. Clin Plast Surg 37(4):553–570CrossRefPubMed Morris SF, Tang M, Almutari K, Geddes C, Yang D (2010) The anatomic basis of perforator flaps. Clin Plast Surg 37(4):553–570CrossRefPubMed
13.
go back to reference Rozen WM, Fox CM, Leong J, Morsi A (2013) The “Chimeric” trapezius muscle and fasciocutaneous flap (dorsal scapular artery perforator flap): a new design for complex 3-dimensional defects. Annals of plastic surgery 71(5):528–532CrossRefPubMed Rozen WM, Fox CM, Leong J, Morsi A (2013) The “Chimeric” trapezius muscle and fasciocutaneous flap (dorsal scapular artery perforator flap): a new design for complex 3-dimensional defects. Annals of plastic surgery 71(5):528–532CrossRefPubMed
14.
go back to reference Sadigh PL, Chang LR, Hsieh CH, Feng WJ, Jeng SF (2014) The trapezius perforator flap: An underused but versatile option in the reconstruction of local and distant soft-tissue defects. Plast Reconstr Surg 134(3):449e-56eCrossRef Sadigh PL, Chang LR, Hsieh CH, Feng WJ, Jeng SF (2014) The trapezius perforator flap: An underused but versatile option in the reconstruction of local and distant soft-tissue defects. Plast Reconstr Surg 134(3):449e-56eCrossRef
15.
go back to reference Salmon M, Grégoire R (1936) Artères de la peau, vol 4. Masson, Paris, pp 123–131 Salmon M, Grégoire R (1936) Artères de la peau, vol 4. Masson, Paris, pp 123–131
16.
go back to reference Salmon M, Dor J (1933) Les artères des muscles des membres et du tronc. Masson, Paris Salmon M, Dor J (1933) Les artères des muscles des membres et du tronc. Masson, Paris
17.
go back to reference Weiglein AH, Haas F, Pierer G (1996) Anatomic basis of the lower trapezius musculocutaneous flap. Surg Radiol Anat 18(4):257–261CrossRefPubMed Weiglein AH, Haas F, Pierer G (1996) Anatomic basis of the lower trapezius musculocutaneous flap. Surg Radiol Anat 18(4):257–261CrossRefPubMed
Metadata
Title
Trapezius perforator flaps: anatomical basis using 58 dissections
Authors
Philippe Manyacka Ma Nyemb
Christian Fontaine
Véronique Martinot-Duquennoy
Xavier Demondion
Jean-Marc Ndoye
Publication date
01-08-2018
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 8/2018
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-018-2044-y

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