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

Authors

  • Yalcin Kulahci M.D.,

    Corresponding author
    1. Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
    • Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic and Reconstructive Surgery, Selimiye Mah. Tibbiye Cad., 34668 Kadiköy/Istanbul, Turkey
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  • Celalettin Sever M.D.,

    1. Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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  • Fatih Uygur M.D.,

    1. Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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  • Sinan Oksuz M.D.,

    1. Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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  • Cihan Sahin M.D.,

    1. Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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  • Haluk Duman M.D.

    1. Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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  • This research was presented at 16th Congress of the Mediterranean Council for Burns and Fire Disasters (MBC), March 31–April 3, 2010, Istanbul, Turkey.

  • Conflict of interest: All authors included in this manuscript have made substantial contributions in the design of the study, and acquisition of data, and analysis and interpretation of data. All of the authors have made contributions in criticizing the manuscript and approving the submission version. This manuscript does not contain any commercial affiliation as well as consultancy, stock, or equity interests. There is no any violation of patent licensing arrangements that could be considered a conflict of interest.

Abstract

Introduction:

The axillary region is one of the sites most frequently affected by postburn contractures. In this clinical study, we used pre-expanded pedicled thoracodorsal artery (TDA) perforator flaps for release of postburn contracture of the axillary region.

Patient and methods:

Five patients with severe axillary burn contractures were reconstructed with six pre-expanded pedicled TDA perforator flaps between 2008 and 2010. All were men ranging in age from 20 to 26 years (mean, 22 years). Mean time of follow-up was 12 months. Flap and donor site complications, preoperative, and postoperative range of motion of axillary joint were evaluated.

Results:

All flaps survived without significant complications. Partial flap necrosis was seen in only one flap. Minimal transient venous congestion occurred in one flap during the early postoperative period. A complete range of motion at the axillary joint was achieved in all patients by the end of the reconstruction period. The donor sites were closed primarily with linear scars in all cases.

Conclusion:

The pre-expanded pedicled TDA perforator flap is a suitable alternative for coverage of the axillary defects after the release of the burn contractures. A pliable texture and large size flap can be obtained to transfer to the axillary area and the donor site scar is considered as cosmetically acceptable. © 2010 Wiley-Liss, Inc. Microsurgery, 2011.

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