Trapezius perforator flap for reconstruction of a posterior cervical defect.

The use of free flaps is considered the "gold standard" for reconstruction of head and neck defects. Locoregional flaps allows a better aesthetic result compared to free flaps, whenever there's an external skin defect. However the use of free flaps is not always adequate in the presence of preoperative comorbidities or previous surgeries. Since the description of the trapezius myocutaneous flap in the 1980's, many authors have published the results of the applicability of this flap in head and neck salvage reconstructive surgery. Nonetheless, the concern with trapezius muscle function remains an important issue. The onset of free-style dissection perforator flaps has attenuated this problem. The authors present a case of a 68 year old man with a posterior cervical wound after a cervical spine trauma, who underwent multiple spine surgeries, successfully treated with an island muscle-sparing trapezius flap. All the details of the dissection technique are outlined. The authors found the trapezius perforator flap to be a reliable and accessible to raise flap with a negligible donor-site morbidity. This flap can be used for occiput, nuchal and spinal areas injuries without the local morbidity related to other flap options.