title: The lower trapezius island myocutaneous flap in tunnelled technique to cover complicated tissue defects located between the craniocervical and cervicothoracic junction following spinal surgery.
abstract: OBJECTIVE
  Stable coverage of complicated defects located between the craniocervical and cervicothoracic junction following wound healing disturbance after spinal surgery can be challenging. Especially in cases where devices are exposed, well-vascularized coverage is required to achieve stable wound conditions. Therefore, the aim of the present study was to evaluate the clinical outcome of the lower trapezius island myocutaneous flap (LTIMF) as a possible treatment option.
  
  
  METHODS
  Four patients with a mean age of 68.8 years (ranging from 50 to 93 years) with wound healing disturbance following spinal surgery leading to defects of the dorsal neck/upper back refractory to conservative treatment and surgical debridement were included. All defects were reconstructed with a LTIMF based on the transverse cervical artery.
  
  
  RESULTS
  Mean follow-up was 16.5 months (ranging from 5 to 30 months). No major flap failure occurred; minor complications in three patients including lateral superficial skin necrosis were easily handled. In all patients, excellent functional and aesthetic results were achieved.
  
  
  CONCLUSIONS
  The lower trapezius island myocutaneous flap represents a reliable treatment option to cover complicated defects located between the craniocervical and cervicothoracic junction following wound disturbance after spinal surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery/Clinical Navigation, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Jan D
authors.initials: JD
authors.lastname: Raguse
authors.affiliation: Department of Neurosurgery, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Czabanka
authors.affiliation: Department of Oral and Maxillofacial Surgery/Clinical Navigation, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Jan Oliver
authors.initials: JO
authors.lastname: Voss
authors.affiliation: Department of Oral and Maxillofacial Surgery/Clinical Navigation, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hartwig
authors.affiliation: Department of Neurosurgery, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Vajkoczy
authors.affiliation: Department of Oral and Maxillofacial Surgery, Universitätsklinikum Freiburg, Germany.
authors.forename: Pit
authors.initials: P
authors.lastname: Voss
authors.affiliation: Department of Oral and Maxillofacial Surgery/Clinical Navigation, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany. Electronic address: Christian.Doll@charite.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Doll
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000601:surgery*; D064171:Superficial Back Muscles / Q000637:transplantation*; D014945:Wound Healing
keywords: Reconstructive surgery; Spinal surgery; Trapezius island myocutaneous flap; Wound healing disturbance