The inframammary extending lateral intercostal artery perforator flap for reconstruction of axillary contractures: a case report

Tissue Expansion and Latissimus Dorsi Transfer for Arm-Thorax Synechia Reconstruction

“…11 The main advantages of axial pattern skin flaps are the lower likelihood of contracture recurrence, the shorter splinting time, and a better quality of new, flexible, and stretchable skin. [12][13][14][15][16][17] Free flaps can be used, but the procedures are relatively difficult and complicated. 18 No matter the classification system used, armthorax synechia, although rare, is the most severe form of axillary contracture.…”

“…However, the size of this flap rules out its use in case of arm-thorax synechia. 15 Free flaps are also supposed to provide satisfactory outcomes in axillary contracture reconstruction, because many free flaps can cover "critical" areas, and some free flaps, for example, the latissimus dorsi, can cover extensive defects. 18 Two-stage reconstruction with two free flaps, which has been reported recently for burn reconstruction, or even simultaneous double free flap transfer can be attempted, but both in exchange of higher risk of total failure and donor-site morbidity.…”

Use of pectoralis major perforators for local “free‐style” perforator flap in axillary reconstruction: A case report

“…The propeller flap based on pectoralis major perforators has minimal morbidity preserving pectoralis major, pectoralis minor, as well as main vascular trunks of thoraco-acromial and lateral thoracic vessels. It can be particularly useful for axillary reconstruction in severe complex axillary and upper lateral thoracic injuries where there is a loss of thoraco-dorsal vessels or lateral intercostal artery perforators 16 while residual muscle function of latissimus-dorsi and pectoralis 17 should be spared. Its distal end can reach well beyond the upper border of the axilla which makes it a very useful option for release and reconstruction after excision of scar contracture in the armpit region.…”

Pre‐expanded pedicled thoracodorsal artery perforator flap for postburn axillary contracture reconstruction

“…Postburn contractures that cause a restricted range of motion have to be released to restore the full functional abilities of the involved joints. Multiple methods have been used for the resurfacing of defects including skin grafts, local flaps, distant flaps, and free tissue transfer 1–15…”

“…The choice of a reconstructive technique for axillary contracture release is usually depends on the patient's condition. The ideal reconstructive method should have the following features: compatible tissue used to replace excised tissue, resistant to recurrent contracture, thin and pliable flap for molding the axillary region contour, and minimal donor site morbidity 3–15. For the first time in the literature, thoracodorsal artery (TDA) perforator flaps were used for correction of axillary burn scar contracture by Kim et al in 2000 4.…”