Coverage of complex tissue defects following open cervicothoracic spine surgery with a lower trapezius island myocutaneous flap-an interdisciplinary approach.


Journal

Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181

Informations de publication

Date de publication:
Feb 2022
Historique:
received: 16 04 2021
accepted: 09 08 2021
revised: 05 06 2021
pubmed: 20 8 2021
medline: 12 2 2022
entrez: 19 8 2021
Statut: ppublish

Résumé

The study design is a clinical case series. The objective of this study was to present the concept and efficacy of the lower trapezius island myocutaneous flap (LTIMF) for management of complex wound healing disorders following open cervicothoracic spine surgery. Wound healing disturbances with myocutaneous defects after open spine surgery at the cervical and upper thoracic spine are well-described complications. In severe cases, plastic reconstructive coverage is often required as a last resort. A review of all adult patients with deep wound dehiscence and tissue defects following open cervicothoracic spine surgery, who were managed with plastic surgery reconstruction using a LTIMF at our institution, was conducted. Synopses of these cases are presented. Seven patients with a mean age of 73 years ± 13 (range 50 to 89 years) were included in this case series. Six out of seven patients had instrumented posterior fusion added to their decompression. All patients were managed with a LTIMF for wound coverage. No spinal implants were removed prior to LTIMF surgery. The mean follow-up was 5.2 months (± 5.4 months). No major flap failure occurred, and all patients presented with satisfactory cosmetic results. The only minor complication was development of a sterile subcutaneous seroma in two patients, which were successfully managed by puncture and aspiration. The LTIMF is an effective and reliable salvage treatment option for spine surgery patients offering stable coverage of deep tissue defects resulting from complex wound healing disorders at the cervical and upper thoracic spine.

Identifiants

pubmed: 34409575
doi: 10.1007/s10143-021-01621-2
pii: 10.1007/s10143-021-01621-2
pmc: PMC8827156
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

883-890

Informations de copyright

© 2021. The Author(s).

Références

Meredith DS, Kepler CK, Huang RC, Brause BD, Boachie-Adjei O (2012) Postoperative infections of the lumbar spine: presentation and management. Int Orthop 36(2):439–444
doi: 10.1007/s00264-011-1427-z
Murphy RC, Robson MC, Heggers JP, Kadowaki M (1986) The effect of microbial contamination on musculocutaneous and random flaps. J Surg Res 41(1):75–80
doi: 10.1016/0022-4804(86)90011-9
Chieng LO, Hubbard Z, Salgado CJ, Levi AD, Chim H (2015) Reconstruction of open wounds as a complication of spinal surgery with flaps: a systematic review. Neurosurg Focus 39(4):E17
doi: 10.3171/2015.7.FOCUS15245
Chun JK, Lynch MJ, Poultsides GA (2003) Distal trapezius musculocutaneous flap for upper thoracic back wounds associated with spinal instrumentation and radiation. Ann Plast Surg 51(1):17–22
doi: 10.1097/01.SAP.0000054242.00928.06
Disa JJ, Smith AW, Bilsky MH (2001) Management of radiated reoperative wounds of the cervicothoracic spine: the role of the trapezius turnover flap. Ann Plast Surg 47(4):394–397
doi: 10.1097/00000637-200110000-00006
Naalla R, Murthy V, Chauhan S, Chinta K, Singhal M (2019) Revisiting the trapezius flap as a reconstructive option for cervico-occipital and thoracic spine regions. Indian J Plast Surg 52(3):322–323
doi: 10.1055/s-0039-3400677
Nascimento R, Costa J, Horta R, Silva A (2017) Trapezius perforator flap for reconstruction of a posterior cervical defect. J Clin Orthop Trauma 8(2):139–141
doi: 10.1016/j.jcot.2017.03.006
Ndayishimiye JM, Husson JL, Watier E (2009) Reconstruction of extensive posterior mid-thoracic soft-tissue defects after spinal surgery on irradiated skin. Orthop Traumatol Surg Res 95(4 Suppl 1):S35-40
doi: 10.1016/j.otsr.2009.03.007
Raguse JD, Czabanka M, Voss JO, Hartwig S, Vajkoczy P, Voss P, Doll C (2016) The lower trapezius island myocutaneous flap in tunnelled technique to cover complicated tissue defects located between the craniocervical and cervicothoracic junction following spinal surgery. J Craniomaxillofac Surg 44(8):969–972
doi: 10.1016/j.jcms.2016.06.005
Seyfer AE (1988) The lower trapezius flap for recalcitrant wounds of the posterior skull and spine. Ann Plast Surg 20(5):414–418
doi: 10.1097/00000637-198805000-00003
Stillaert FB, Van Landuyt K (2009) Stable coverage of a cervico-thoracic defect with an extended lower trapezius myocutaneous flap. J Plast Reconstr Aesthet Surg 62(5):e101–e102
doi: 10.1016/j.bjps.2008.08.066
Weiglein AH, Haas F, Pierer G (1996) Anatomic basis of the lower trapezius musculocutaneous flap. Surg Radiol Anat 18(4):257–261
doi: 10.1007/BF01627601
Casper DS, Zmistowski B, Hollern DA, Hilibrand AS, Vaccaro AR, Schroeder GD, Kepler CK (2018) The effect of postoperative spinal infections on patient mortality. Spine (Phila Pa 1976) 43(3):223–227
doi: 10.1097/BRS.0000000000002277
Chieng LO, Hubbard Z, Salgado CJ, Levi AD, Chim H (2015) Reconstruction of open wounds as a complication of spinal surgery with flaps: a systematic review. Neurosurgical Focus FOC 39(4):E17
doi: 10.3171/2015.7.FOCUS15245
Duetzmann S, Cole T, Senft C, Seifert V, Ratliff JK, Park J (2015) Clavicle pain and reduction of incisional and fascial pain after posterior cervical surgery. J Neurosurg Spine SPI 23(6):684
doi: 10.3171/2015.2.SPINE141118
Seo DK, Park JH, Oh SK, Ahn Y, Jeon SR (2018) Practicality of using the figure-of-eight bandage to prevent fatal wound dehiscence after spinal tumor surgery for upper thoracic metastasis. Br J Neurosurg 32(4):389–395
doi: 10.1080/02688697.2017.1400520
McCraw JB, Magee WP Jr, Kalwaic H (1979) Uses of the trapezius and sternomastoid myocutaneous flaps in head and neck reconstruction. Plast Reconstr Surg 63(1):49–57
doi: 10.1097/00006534-197901000-00009
Demergasso F, Piazza MV (1979) Trapezius myocutaneous flap in reconstructive surgery for head and neck cancer: an original technique. Am J Surg 138(4):533–536
doi: 10.1016/0002-9610(79)90414-8
Baek SM, Biller HF, Krespi YP, Lawson W (1980) The lower trapezius island myocutaneous flap. Ann Plast Surg 5(2):108–114
doi: 10.1097/00000637-198008000-00004
Mathes SJ, Nahai F (1980) Muscle flap transposition with function preservation: technical and clinical considerations. Plast Reconstr Surg 66(2):242–249
doi: 10.1097/00006534-198008000-00013
Andrieu-Guitrancourt J, Peron JM, Dehesdin D, Fouin M (1984) Lower trapezius musculocutaneous flap for the repair of neoplastic loss of substance of the ear. Ann Otolaryngol Chir Cervicofac 101(7):545–548
pubmed: 6391337
Chen WL, Deng YF, Peng GG, Li JS, Yang ZH, Bai ZB, Huang ZQ, Wang JG, Zhang B (2007) Extended vertical lower trapezius island myocutaneous flap for reconstruction of cranio-maxillofacial defects. Int J Oral Maxillofac Surg 36(2):165–170
doi: 10.1016/j.ijom.2006.06.022
Chen WL, Yang ZH, Li JS, Huang ZQ (2008) Reconstruction of the tongue using an extended vertical lower trapezius island myocutaneous flap after removal of advanced tongue cancer. Br J Oral Maxillofac Surg 46(5):379–382
doi: 10.1016/j.bjoms.2007.11.009
Cole I (1997) The lower trapezius island myocutaneous flap for reconstruction of soft tissue of the lateral skullbase and neck. Aust N Z J Surg 67(7):452–456
doi: 10.1111/j.1445-2197.1997.tb02013.x
Elshaer WM (2004) Extended lower trapezius island myocutaneous flap in the repair of postburn axillary contracture. Plast Reconstr Surg 113(7):2076–81. discussion 2082–4
Krespi YP, Baek SM, Surek CL (1983) Flap reconstruction of the upper face: free flaps vs. lower trapezius myocutaneous flap. Laryngoscope 93(4):485–8
doi: 10.1002/lary.1983.93.4.485
Singh M, Rios Diaz AJ, Cauley R, Smith TR, Caterson EJ (2015) Use of pedicled trapezius myocutaneous flap for posterior skull reconstruction. J Craniofac Surg 26(6):e532–e535
doi: 10.1097/SCS.0000000000002033
Yoshimura Y, Maruyama Y, Takeuchi S (1981) The use of lower trapezius myocutaneous island flaps in head and neck reconstruction. Br J Plast Surg 34(3):334–337
doi: 10.1016/0007-1226(81)90024-2
Zhou MJ, Chen XH, Kou XJ, Wang BC (2020) A new method: lower trapezius island myocutaneous flap to repair surgical defect in lateral skull base cancer after radiotherapy. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 55(4):410–412
pubmed: 32306644

Auteurs

Armin Osmanagic (A)

Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16, 3010, Bern, Switzerland.

Alessa Schütz (A)

Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16, 3010, Bern, Switzerland.

Ivo Bayard (I)

Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Andreas Raabe (A)

Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16, 3010, Bern, Switzerland.

Radu Olariu (R)

Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Ralph T Schär (RT)

Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16, 3010, Bern, Switzerland. ralph.schaer@insel.ch.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH