Prior radical neck dissection has no bearing on the use of the superior trapezius flap; in fact, resection of the transverse cervical artery serves to delay the flap thus improving its distal vascularity (32). This flap is very hardy and will survive in open infected and irradiated wounds, making it very useful for difficult situations where soft tissue coverage is crucial in the lateral and upper neck.

The lower island trapezius flap offers thin, pliable tissue and is unaffected by variations in the anatomy of the transverse cervical artery and vein, unlike the lateral island flap. The donor site can be closed primarily and is the least conspicuous of all the trapezius family of flaps. It also offers the longest arc of rotation.

The lateral island flap also offers thin pliable tissue for a variety of defects in the ipsilateral head and neck and the patient does not have to be placed in the full lateral decubitus position for flap harvest.

Figure 18 Lower island trapezius flap raised and pedicled before final inset on left. On right, the flap is inset to fill the defect.
Figure 19 The dorsal scapular arterial supply to the lower island trapezius muscle (arrows).
How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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