International Journal of Contemporary Surgery
  • Year: 2017
  • Volume: 5
  • Issue: 2

A Study of Reconstruction of Axillary Burn Scar Contracture with Scapular and Parascapular Flaps

1Assistant Professor, Post Graduate Department of General Surgery, Saraswathi Institute of Medical Sciences, Hapur, UP

2Associate Professor, Post Graduate Department of General Surgery, Saraswathi Institute of Medical Sciences, Hapur, UP

Online published on 2 September, 2017.

Abstract

Burns around cervicofacial region are common and frequently lead to contracture formation. Involvement of axillary folds results in adduction contracture limiting full motion at shoulder joint. A variety of surgical methods are advocated depending on patient's condition and state of surrounding soft time scarring of axillary folds and chest wall. The fasciocutaneous flaps like scapular, parascapular and thoracodorsal perforator based cutaneous flaps are used as island for the treatment of the obliterated axilla.

In the present study entitled ‘A study of Reconstruction of Axillary scar contracture with scapular and parascapular flaps’ the feasibility, utility and durability of these flaps is evaluated.

To study feasibility, utility and durability of scapular and parascapular flaps in reconstruction of Axillary Scar contracture.

Prospective study from July 2009 to June 2011.

Department of General Surgery, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, UP.

Patients of post burn axillary contracture.

Out of 22 patients of axillary scar contractures 10 patients were included in study group.

Out of 10 patients 7 (70%) were male and 3 (30%) were female though flame burns are more common in females.

The age range was between 11–40 years. Majority cases 8 patients (80%) belong to 31–40 years of age.

Most common cause of axillary contracture was flame burn in 6 patients (60%).

Scapular flaps were used in 2 cases while parascapular flaps were used in 8 cases.

The largest flap was 18 X 10 cm while smallest flap was 6 X 10 cm.

Donor site was closed primarily in 8 cases while split thickness skin grafting was done in 2 cases.

All flaps survived except one due to inadequate haemostasis causing compression of pedicle due to collection of haematoma.

Commonest donor site complain was stretched scare in two cases while it was negligible in rest of the cases.

Maximum shoulder abduction achieved was 130°.

The scapular and parascapular flaps are versatile and reliable for reconstructing all forms of axillary contractures.

Keywords

Axilla, Contracture, Scapular, Parascapular, Flap