Comparing different modalities of managing postburn axillary contracture

Abstract

Introduction: Axillary postburn scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction that should be achieved. The aim of this study is to highlight the various management options used in managing axillary contractures in our hospital and to minimize the complications commonly encountered. Aims and Objective: The aim and objective of this study is (1) to evaluate different options for postburn axillary contracture treatment, (2) the functional outcome of different treatment methods, and (3) late squeals of treatment. Materials and Methods: It is a prospective study which was conducted at the department of plastic surgery. Axillary contracture was released and resurfaced using split skin graft and/or with different types of flaps, including the Single Z plasty, Multiple Z plasty, Five flap plasty, Local fasciocuteneous flap, Propeller flap, and Parascapular flap. Results: Eighteen patients were operated. Surgical treatment included split-thickness skin graft in five cases, square flap in three cases and square flap with split thickness graft in two cases, Multipe Z-plasties in two cases and Multipe Z plasty with split-thickness graft in one case, Parascapular flaps with split thickness graft in two cases, while five flap plasty in three cases. Conclusion: Mean degree of abduction is maintain or increased in follow-up (after 6 month) is Square flap, Multiple Z plasty, five flap plasty, and Parascapular flap. Mean degree of abduction is decreased in split thickness graft in follow-up (after 6 month).