Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Delayed Lower Trapezius Myocutaneous Flap for Reconstruction of Posterior Scalp Defects: A Retrospective Study
Posterior Skalp Defektlerinin Rekonstrüksiyonunda Geciktirme Uygulanmış Alt Trapezius Miyokutanöz Flep: Retrospektif Çalışma
Ayhan Işık ERDALa , Mert DORUKa , Serhat ŞİBARa
aGazi University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Türkiye
Turkiye Klinikleri J Med Sci. 2024;44(2):85-90
doi: 10.5336/medsci.2023-100966
Article Language: EN
Full Text
ABSTRACT
 Objective: The lower trapezius myocutaneous flap is useful for reconstructing posterior scalp defects. It is recommended that the skin island should not extend more than 10 cm below the inferior angle of the scapula. To design a flap that exceeds these limits and extends more caudally without compromising blood supply, we needed to make a modification and decided to apply a surgical delay procedure. In this study, we present our modified lower trapezius myocutaneous flap technique, in which the surgical delay is applied in the first session, and flap transfer is performed in the second session. Material and Methods: Patients who had reconstruction of scalp defect with delayed lower trapezius myocutaneous flap between January 2018 and December 2022 were analyzed retrospectively. Seven patients were included in the study. The demographic characteristics of the patients, the characteristics of the defects, the characteristics of the flaps, and the outcomes of the reconstruction were analyzed. Results: Of the 7 patients in the study, 5 were men, and 2 were women. The mean age of the patients was 56 years (range: 42-62 years). All defects were full-thickness scalp defects. All patients had uneventful wound healing and defect closure. There were no complications. Conclusion: A delayed lower trapezius myocutaneous flap can be used safely in posterior scalp defects close to the vertex.

Keywords: Trapezius flap; myocutaneous flap; superficial back muscles; scalp
ÖZET
 Amaç: Alt trapezius miyokutanöz flep, posterior skalp defektlerinin rekonstrüksiyonu için kullanışlı bir seçenektir. Deri adasının skapula inferior köşesinden 10 cm'den daha aşağıya uzanmaması önerilir. Bu sınırlılıkları aşarak ve kan akışını bozmadan kaudale doğru daha fazla uzanabilen bir flep tasarlamak için bir modifikasyona ihtiyaç duyduk ve cerrahi geciktirme prosedürünü uygulamaya karar verdik. Bu çalışmada, ilk seansta cerrahi geciktirmenin uygulandığı, ikinci seansta ise flep transferinin yapıldığı modifiye alt trapezius miyokutanöz flep tekniğimiz sunulmuştur. Gereç ve Yöntemler: Ocak 2018 ile Aralık 2022 tarihleri arasında cerrahi geciktirme uygulanmış alt trapezius miyokutanöz flep ile skalp defekti rekonstrüksiyonu yapılan hastalar retrospektif olarak incelendi. Çalışmaya 7 hasta dâhil edildi. Hastaların demografik özellikleri, defektlerin özellikleri, fleplerin özellikleri ve rekonstrüksiyon sonuçları analiz edildi. Bulgular: Çalışmaya dâhil edilen 7 hastanın 5'i erkek, 2'si kadındı. Hastaların ortalama yaşı 56 (aralık: 42-62) idi. Tüm defektler tam kat saçlı deri defektleriydi. Tüm hastalarda sorunsuz yara iyileşmesi ve defekt kapatılması gerçekleşti. Komplikasyon olmadı. Sonuç: Geciktirme uygulanmış alt trapezius miyokutanöz flep vertekse yakın posterior skalp defektlerinde güvenle kullanılabilir.

Anahtar Kelimeler: Trapezius flep; miyokutanöz flep; yüzeyel sırt kasları; saçlı deri
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