Surgical Treatment of Complex Axillary Scare Contractures: One Case Report

Abstract

Background: Axillary scar contracture is frequently observed after severe burn insult and is usually accompanied by scarred adjacent area. These scars result in adduction deformity, which may be severe and diffuse. The lack of adequate treatment in the acute phase leads to complex scars that require different surgical techniques depending on the clinical examination of surgeon. Aim: Expose the possible surgical techniques, their advantages and disadvantages in the case of burning of the entire axillary hollow. The surgical management of linear scares contractures will not be discussed in this article. Case presentation: This is a rare clinical case of a 12-year-old girl who was burned at the age of 5 with disabling functional sequelae of the axillary area (limitation of the abduction to 30 degrees). The patient is treated at ALGHASSANI Hospital in Fes city/Morocco. Parental consent was taken for scientific publication. Results: We did two surgical interventions: the first starting with excision of the scar tissue leaving a loss of skin covered by a laterothoracic IC fasciocutaneous flap. The second one was a semi-thick skin graft to cover the supero and infero external quadrants of the left breast. We obtain the abduction at 110 degrees. Conclusion: Early surgical management of deep lesions within 21 days of the burn associated with prolonged rehabilitation and the wearing of compression garments and splints are essential elements in the prevention of these axillary contractures.