Tayla Moshal, Sasha Lasky, Idean Roohani, Marah I Jolibois, Artur Manasyan, Naikhoba C O Munabi, Artur Fahradyan, Jessica A Lee, Jeffrey A Hammoudeh
{"title":"被遗忘的皮瓣：带蒂斜方肌皮瓣在小儿头颈部重建中的实用性--系统性综述。","authors":"Tayla Moshal, Sasha Lasky, Idean Roohani, Marah I Jolibois, Artur Manasyan, Naikhoba C O Munabi, Artur Fahradyan, Jessica A Lee, Jeffrey A Hammoudeh","doi":"10.1055/s-0044-1787741","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong> When free tissue transfer is precluded or undesired, the pedicled trapezius flap is a viable alternative for adults requiring complex head and neck (H&N) defect reconstruction. However, the application of this flap in pediatric reconstruction is underexplored. This systematic review aimed to describe the use of the pedicled trapezius flap and investigate its efficacy in pediatric H&N reconstruction.</p><p><strong>Methods: </strong> A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles describing the trapezius flap for H&N reconstruction in pediatric patients were included. Patient demographics, surgical indications, wound characteristics, flap characteristics, complications, and functional outcomes were abstracted.</p><p><strong>Results: </strong> A systematic review identified 22 articles for inclusion. Studies mainly consisted of case reports (<i>n</i> = 11) and case series (<i>n</i> = 8). In total, 67 pedicled trapezius flaps were successfully performed for H&N reconstruction in 63 patients. The most common surgical indications included burn scar contractures (<i>n</i> = 46, 73.0%) and chronic wounds secondary to H&N masses (<i>n</i> = 9, 14.3%). Defects were most commonly located in the neck (<i>n</i> = 28, 41.8%). The mean flap area and arc of rotation were 326.4 ± 241.7 cm<sup>2</sup> and 157.6 ± 33.2 degrees, respectively. Most flaps were myocutaneous (<i>n</i> = 48, 71.6%) and based on the dorsal scapular artery (<i>n</i> = 32, 47.8%). Complications occurred in 10 (14.9%) flaps. The flap's survival rate was 100% (<i>n</i> = 67). No instances of functional donor site morbidity were reported. The mean follow-up was 2.2 ± 1.8 years.</p><p><strong>Conclusion: </strong> This systematic review demonstrated the reliability of the pedicled trapezius flap in pediatric H&N reconstruction, with a low complication rate, no reports of functional donor site morbidity, and a 100% flap survival rate. The flap's substantial surface area, bulk, and arc of rotation contribute to its efficacy in covering soft tissue defects ranging from the proximal neck to the vertex of the scalp. The pedicled trapezius flap is a viable option for pediatric H&N reconstruction.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"113-122"},"PeriodicalIF":2.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Forgotten Flap: The Pedicled Trapezius Flap's Utility in Pediatric Head and Neck Reconstruction-A Systematic Review.\",\"authors\":\"Tayla Moshal, Sasha Lasky, Idean Roohani, Marah I Jolibois, Artur Manasyan, Naikhoba C O Munabi, Artur Fahradyan, Jessica A Lee, Jeffrey A Hammoudeh\",\"doi\":\"10.1055/s-0044-1787741\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong> When free tissue transfer is precluded or undesired, the pedicled trapezius flap is a viable alternative for adults requiring complex head and neck (H&N) defect reconstruction. However, the application of this flap in pediatric reconstruction is underexplored. This systematic review aimed to describe the use of the pedicled trapezius flap and investigate its efficacy in pediatric H&N reconstruction.</p><p><strong>Methods: </strong> A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles describing the trapezius flap for H&N reconstruction in pediatric patients were included. Patient demographics, surgical indications, wound characteristics, flap characteristics, complications, and functional outcomes were abstracted.</p><p><strong>Results: </strong> A systematic review identified 22 articles for inclusion. Studies mainly consisted of case reports (<i>n</i> = 11) and case series (<i>n</i> = 8). In total, 67 pedicled trapezius flaps were successfully performed for H&N reconstruction in 63 patients. The most common surgical indications included burn scar contractures (<i>n</i> = 46, 73.0%) and chronic wounds secondary to H&N masses (<i>n</i> = 9, 14.3%). Defects were most commonly located in the neck (<i>n</i> = 28, 41.8%). The mean flap area and arc of rotation were 326.4 ± 241.7 cm<sup>2</sup> and 157.6 ± 33.2 degrees, respectively. Most flaps were myocutaneous (<i>n</i> = 48, 71.6%) and based on the dorsal scapular artery (<i>n</i> = 32, 47.8%). Complications occurred in 10 (14.9%) flaps. The flap's survival rate was 100% (<i>n</i> = 67). No instances of functional donor site morbidity were reported. The mean follow-up was 2.2 ± 1.8 years.</p><p><strong>Conclusion: </strong> This systematic review demonstrated the reliability of the pedicled trapezius flap in pediatric H&N reconstruction, with a low complication rate, no reports of functional donor site morbidity, and a 100% flap survival rate. The flap's substantial surface area, bulk, and arc of rotation contribute to its efficacy in covering soft tissue defects ranging from the proximal neck to the vertex of the scalp. The pedicled trapezius flap is a viable option for pediatric H&N reconstruction.</p>\",\"PeriodicalId\":16949,\"journal\":{\"name\":\"Journal of reconstructive microsurgery\",\"volume\":\" \",\"pages\":\"113-122\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of reconstructive microsurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0044-1787741\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of reconstructive microsurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/s-0044-1787741","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/25 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
The Forgotten Flap: The Pedicled Trapezius Flap's Utility in Pediatric Head and Neck Reconstruction-A Systematic Review.
Background: When free tissue transfer is precluded or undesired, the pedicled trapezius flap is a viable alternative for adults requiring complex head and neck (H&N) defect reconstruction. However, the application of this flap in pediatric reconstruction is underexplored. This systematic review aimed to describe the use of the pedicled trapezius flap and investigate its efficacy in pediatric H&N reconstruction.
Methods: A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles describing the trapezius flap for H&N reconstruction in pediatric patients were included. Patient demographics, surgical indications, wound characteristics, flap characteristics, complications, and functional outcomes were abstracted.
Results: A systematic review identified 22 articles for inclusion. Studies mainly consisted of case reports (n = 11) and case series (n = 8). In total, 67 pedicled trapezius flaps were successfully performed for H&N reconstruction in 63 patients. The most common surgical indications included burn scar contractures (n = 46, 73.0%) and chronic wounds secondary to H&N masses (n = 9, 14.3%). Defects were most commonly located in the neck (n = 28, 41.8%). The mean flap area and arc of rotation were 326.4 ± 241.7 cm2 and 157.6 ± 33.2 degrees, respectively. Most flaps were myocutaneous (n = 48, 71.6%) and based on the dorsal scapular artery (n = 32, 47.8%). Complications occurred in 10 (14.9%) flaps. The flap's survival rate was 100% (n = 67). No instances of functional donor site morbidity were reported. The mean follow-up was 2.2 ± 1.8 years.
Conclusion: This systematic review demonstrated the reliability of the pedicled trapezius flap in pediatric H&N reconstruction, with a low complication rate, no reports of functional donor site morbidity, and a 100% flap survival rate. The flap's substantial surface area, bulk, and arc of rotation contribute to its efficacy in covering soft tissue defects ranging from the proximal neck to the vertex of the scalp. The pedicled trapezius flap is a viable option for pediatric H&N reconstruction.
期刊介绍：
The Journal of Reconstructive Microsurgery is a peer-reviewed, indexed journal that provides an international forum for the publication of articles focusing on reconstructive microsurgery and complex reconstructive surgery. The journal was originally established in 1984 for the microsurgical community to publish and share academic papers.
The Journal of Reconstructive Microsurgery provides the latest in original research spanning basic laboratory, translational, and clinical investigations. Review papers cover current topics in complex reconstruction and microsurgery. In addition, special sections discuss new technologies, innovations, materials, and significant problem cases.
The journal welcomes controversial topics, editorial comments, book reviews, and letters to the Editor, in order to complete the balanced spectrum of information available in the Journal of Reconstructive Microsurgery. All articles undergo stringent peer review by international experts in the specialty.
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