• Parviz L Sadigh, Li-Ren Chang, Ching-Hua Hsieh, Wen-Jui Feng, and Seng-Feng Jeng.
• 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.
• Plast. Reconstr. Surg. 2014 Sep 1;134(3):449e-456e.

BackgroundThe 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.MethodsTen 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.ResultsSix 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.ConclusionsThe 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.Clinical Question/Level Of EvidenceTherapeutic, IV.

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