Free tissues transfer has been well-described in infants but there is limited data on techniques for reconstruction of large neck defects with regional myocutaneous flaps in this population. We report on the use of a lower island trapezius myocutaneous flap to reconstruct a large posterior neck and occiput wound in an 18-month-old child. The use of a regional myocutaneous flap allowed for reliable transfer of a relatively large volume of skin and soft tissue, providing coverage of the internal jugular vein and spinal accessory nerve as well as limiting the likelihood of debilitating scar contracture.
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