Trapezius Muscle Flap for Posterior Neck and Shoulder Defects Following Malignant Tumor Resection-A Case Series from a Tertiary Cancer Facility

斜方肌肌瓣修复恶性肿瘤切除术后颈后肩部缺损——来自三级肿瘤专科医院的病例系列研究

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Abstract

Reconstructing defects of the shoulder and posterior scalp, arising following tumor resection, requires careful consideration of available options. While free tissue transfers and local advancement flaps have their established roles, the trapezius muscle flap offers a unique set of advantages like proximity, versatility, and reliability as it has a robust blood supply and relatively straightforward surgical technique. In this retrospective analysis, demographic and disease profiles of 10 patients with posterior scalp and shoulder defects following tumor resection, which were reconstructed with a trapezius flap between November 2020 and November 2023, were studied. Complications and functional outcomes were analyzed. Ten patients (9 men and 1 woman) were reconstructed using a trapezius flap. The mean age of the study sample was 45.3 years (30-60 years). Two patients developed donor site seroma and one of them developed wound dehiscence; one patient had partial necrosis of the flap tip, all managed conservatively, and one patient had tumor recurrence. However, the long-term result was good in all patients except the one with recurrence. The post-excision defects in the shoulder and posterior scalp were of mean size 13 ± 2 × 6 ± 2 cm, and the donor site morbidity analyzed by using VAS (visual analog scale) had a mean score of less than 3. This case series provides valuable insights into the successful use of the trapezius muscle flap for shoulder and posterior scalp defects following malignant tumor resection. The documented complications are minimal in comparison to the overall positive outcomes, making the trapezius muscle flap a viable and reliable option for reconstruction in this specific clinical scenario. However, further research is required to improve the design of the flap for different types of defects, refine surgical techniques, and compare outcomes with other reconstruction methods.

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