title: Trapezius Rotational Flap for Cervico-thoracic Wound Breakdown in Post-radiotherapy Necrosis : A Case Report.
abstract: The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with postradiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.
  
  
  BACKGROUND
  lower trapezius flap, scapula-thoracic function, postradiation necrosis.
authors.affiliation: Department of Orthopaedic and Traumatology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Mh
authors.initials: M
authors.lastname: Ariffin
authors.affiliation: Department of Orthopaedic and Traumatology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Selvyn
authors.initials: S
authors.lastname: Lloyd
authors.affiliation: Department of Orthopaedic and Traumatology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Sa
authors.initials: S
authors.lastname: Rhani
authors.affiliation: Department of Orthopaedic and Traumatology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.lastname: Kamalnizat
authors.affiliation: Department of Orthopaedic and Traumatology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Baharudin