title: The trapezius perforator flap: an underused but versatile option in the reconstruction of local and distant soft-tissue defects.
abstract: BACKGROUND
  The trapezius myocutaneous flap is an established reconstructive option in head and neck cases The authors present their experience with 10 trapezius perforator flaps, all raised using a freestyle technique of perforator dissection, to successfully reconstruct both local and distant soft-tissue defects.
  
  
  METHODS
  Ten patients underwent soft-tissue reconstruction using trapezius perforator flaps. After mapping the perforator with a handheld Doppler device at the intersection of a horizontal line drawn 6 to 8 cm inferior to the scapular spine and a vertical line drawn 8 to 9 cm lateral to the midline of the back, perforator flaps were raised in a freestyle fashion, with complete preservation of the trapezius muscle. The flap can be pedicled into local defects or transferred as a free flap.
  
  
  RESULTS
  Six flaps were elevated as pedicled flaps and four were transferred as free flaps. Flap size ranged from 6 × 4 cm to 25 × 15 cm. The pedicle length ranged from 4 to 14 cm. The pedicle originated from the dorsal scapular artery. In one case, the authors converted from a pedicled flap to a free flap secondary to insufficient pedicle length. All donor sites were closed directly. The follow-up period ranged from 4 months to 4 years. All of the flaps survived completely with no major complications, and no patients developed any shoulder dysfunction.
  
  
  CONCLUSIONS
  The trapezius perforator flap is a reliable and versatile reconstructive option that can be used to repair both local and distant soft-tissue defects. The donor-site morbidity is minimal.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Kaohsiung, Taiwan From the Departments of Plastic Surgery and Management, E-Da Hospital, I-Shou University; and the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital.
authors.forename: Parviz L
authors.initials: PL
authors.lastname: Sadigh
authors.forename: Li-Ren
authors.initials: LR
authors.lastname: Chang
authors.forename: Ching-Hua
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Wen-Jui
authors.initials: WJ
authors.lastname: Feng
authors.forename: Seng-Feng
authors.initials: SF
authors.lastname: Jeng
mesh_terms: D000328:Adult; D004210:Dissection / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply / Q000637:transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D061525:Perforator Flap / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods*; D064171:Superficial Back Muscles / Q000033:anatomy & histology / Q000098:blood supply / Q000601:surgery* / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply