Surgical and Radiologic Anatomy

, Volume 40, Issue 8, pp 903–910 | Cite as

Trapezius perforator flaps: anatomical basis using 58 dissections

  • Philippe Manyacka Ma NyembEmail author
  • Christian Fontaine
  • Véronique Martinot-Duquennoy
  • Xavier Demondion
  • Jean-Marc Ndoye
Original Article



The trapezius muscle is a good option for soft tissue defects in the cervical and thoracic regions. However, pedicled flaps raised from perforators in the trapezius are rare. Through a series of cadaver dissections, the authors aim to map the perforating arteries in the trapezius muscle.

Materials and methods

Dissection of 58 anatomical regions in 32 cadavers was carried out. The perforating arteries of the trapezius were inventoried based on their location, dimensions and frequency using the scapular spine and spinous process line as landmarks.


In 78% of cases, the main perforators of the trapezius were located along two vertical lines parallel to the spinous process line, 5–6 cm on either side of it, between the scapular spine laterally, the tip of the scapula caudally and the superior margin of the trapezius cranially. On each side of the spinous process line, we found an average of 16 perforators (range 5–27) with an average diameter of 0.6 mm (range 0.1–2.6 mm).


Our study shows that surgeons can use fixed landmarks when developing trapezius perforator flaps.


Dorsal scapular artery Perforator flaps Trapezius 



The authors are grateful for the contribution of the entire staff of the Lille University Anatomy Laboratory (France) to this work, along with the staff of the Radiology Department of the Lille University Hospital.


  1. 1.
    Angrigiani C, Grilli D, Karanas YL, Longaker MT, Sharma S (2003) The dorsal scapular island flap: an alternative for head, neck, and chest reconstruction. Plast Reconstr Surg 111(1):67–78CrossRefPubMedGoogle Scholar
  2. 2.
    Baek SM, Biller HF, Krespi YP, Lawson W (1980) The lower trapezius island myocutaneous flap. Ann Plast Surg 5(2):108–114CrossRefPubMedGoogle Scholar
  3. 3.
    Blondeel PN, Morris SF, Hallock GG, Neligan PC (2013) Perforator flaps: anatomy, technique, clinical applications. CRC Press, Boca RatonGoogle Scholar
  4. 4.
    Boucher F, Mojallal A (2015) Atlas des artères perforantes de la peau, du tronc et des membres. Elsevier Masson, ParisGoogle Scholar
  5. 5.
    Haas F, Weiglein A, Schwarzl F, Scharnagl E (2004) The lower trapezius musculocutaneous flap from pedicled to free flap: anatomical basis and clinical applications based on the dorsal scapular artery. Plast Reconstr Surg 113(6):1580–1590CrossRefPubMedGoogle Scholar
  6. 6.
    Hafezi F, Naghibzadeh B, Pegahmehr M, Boddouhi N, Nouhi A (2008) Extended vertical trapezius fasciocutaneous flap (back flap) in face and neck burn scar reconstruction. Ann Plast Surg 61(4):441–446CrossRefPubMedGoogle Scholar
  7. 7.
    Hamdi M, Stillaert FB (2010) Pedicled perforator flaps in the trunk. Clin Plast Surg 37(4):655–665CrossRefPubMedGoogle Scholar
  8. 8.
    Ikka L, Mihalea C, Achour NB, Khalek HA, Vacher C (2016) The origin of the dorsal scapular artery: anatomic variations and surgical applications. Surg Radiol Anat 38(9):1–7CrossRefGoogle Scholar
  9. 9.
    Lynch JR, Hansen JE, Chaffoo R, Seyfer AE (2002) The lower trapezius musculocutaneous flap revisited: versatile coverage for complicated wounds to the posterior cervical and occipital regions based on the deep branch of the transverse cervical artery. Plast Reconstr Surg 109(2):444–450CrossRefPubMedGoogle Scholar
  10. 10.
    Maruyama Y, Nakajima H, Fujino T, Koda E (1981) The definition of cutaneous vascular territories over the back using selective angiography and the intra-arterial injection of prostaglandin E1: some observations on the use of the lower trapezius myocutaneous flap. Brit J Plast Surg 34(2):157–161CrossRefPubMedGoogle Scholar
  11. 11.
    Mathes SJ, Nahai F (1981) Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg 67(2):177–187CrossRefPubMedGoogle Scholar
  12. 12.
    Morris SF, Tang M, Almutari K, Geddes C, Yang D (2010) The anatomic basis of perforator flaps. Clin Plast Surg 37(4):553–570CrossRefPubMedGoogle Scholar
  13. 13.
    Rozen WM, Fox CM, Leong J, Morsi A (2013) The “Chimeric” trapezius muscle and fasciocutaneous flap (dorsal scapular artery perforator flap): a new design for complex 3-dimensional defects. Annals of plastic surgery 71(5):528–532CrossRefPubMedGoogle Scholar
  14. 14.
    Sadigh PL, Chang LR, Hsieh CH, Feng WJ, Jeng SF (2014) The trapezius perforator flap: An underused but versatile option in the reconstruction of local and distant soft-tissue defects. Plast Reconstr Surg 134(3):449e-56eCrossRefGoogle Scholar
  15. 15.
    Salmon M, Grégoire R (1936) Artères de la peau, vol 4. Masson, Paris, pp 123–131Google Scholar
  16. 16.
    Salmon M, Dor J (1933) Les artères des muscles des membres et du tronc. Masson, ParisGoogle Scholar
  17. 17.
    Weiglein AH, Haas F, Pierer G (1996) Anatomic basis of the lower trapezius musculocutaneous flap. Surg Radiol Anat 18(4):257–261CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Philippe Manyacka Ma Nyemb
    • 1
    • 2
    Email author
  • Christian Fontaine
    • 3
  • Véronique Martinot-Duquennoy
    • 4
  • Xavier Demondion
    • 3
    • 5
  • Jean-Marc Ndoye
    • 6
  1. 1.Department of Anatomy and OrganogenesisUFR 2S, Gaston Berger UniversitySaint-LouisSenegal
  2. 2.Department of General SurgeryRegional HospitalSaint-LouisSenegal
  3. 3.Department of Anatomy and Organogenesis, Henri Warembourg Faculty of MedicineUniversité de Lille 2LilleFrance
  4. 4.Department of Plastic, Esthetic and Reconstructive Surgery, Roger Salengro HospitalLille University HospitalLilleFrance
  5. 5.Department of Musculoskelettal Imaging, Roger Salengro HospitalLille University HospitalLilleFrance
  6. 6.Department of Anatomy and OrganogenesisCheikh Anta Diop UniversityDakarSenegal

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