c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Trapezius Flap: 1

A D V E R T I S E M E N T

   
 

A 59-year-old female patient status post spinal surgery presents with an open wound on the posterior aspect of her neck. The deformity is measured to be 10cm x 5 cm and extends down to the bone.       

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Trapezius Flap: 2

A D V E R T I S E M E N T

   
 

The patient is marked to designate the outlines of her scapula, trapezius, and the oval island that will be dissected. The landmarks used for the borders of the island are: medially- the posterior midline, superiorly- the midpoint of the scapula, laterally- the vertebral border of the scapula, and inferiorly- midpoint between the tip of the scapula and posterior superior iliac crest.      

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Trapezius Flap: 3

A D V E R T I S E M E N T

   
 

The patient is put under general anesthesia in the prone position with arms abducted at 90. The ipsilateral shoulder is lowered to allow for lateral rotation of the scapula. The arm is left flexible in order to allow for intraoperative shifting of the scapula due to the anatomy of the perforating vessels, which are located just under the medial margin of the scapula.      

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This page was last modified on 4/14/2016.