title: 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.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, Dandenong; and †Department of Surgery, Faculty of Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: Warren M
authors.initials: WM
authors.lastname: Rozen
authors.forename: Carly M
authors.initials: CM
authors.lastname: Fox
authors.forename: James
authors.initials: J
authors.lastname: Leong
authors.forename: Adel
authors.initials: A
authors.lastname: Morsi
mesh_terms: D006085:Graft Survival; D006801:Humans; D064827:Myocutaneous Flap / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods*; D064171:Superficial Back Muscles / Q000098:blood supply / Q000637:transplantation*; D013524:Surgical Flaps; D020858:Tissue and Organ Harvesting / Q000379:methods*