Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Microsurgery. 2011 Jan;31(1):26-31. doi: 10.1002/micr.20825. Epub 2010 Nov 12.
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.
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.
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.
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.
腋窝是最常发生烧伤后挛缩的部位之一。在这项临床研究中，我们使用预扩张的胸背动脉（TDA）穿支皮瓣来松解腋窝烧伤后挛缩。
2008 年至 2010 年期间，我们使用六块预扩张的带蒂胸背动脉穿支皮瓣对 5 例严重腋窝烧伤挛缩患者进行了重建。所有患者均为男性，年龄 20 至 26 岁（平均 22 岁）。平均随访时间为 12 个月。评估了皮瓣和供区并发症、术前和术后腋窝关节活动范围。
所有皮瓣均存活，无明显并发症。仅在 1 个皮瓣中观察到部分皮瓣坏死。在术后早期，1 个皮瓣出现短暂的静脉淤血。在重建期末，所有患者的腋窝关节均达到完全活动范围。所有病例均采用线性瘢痕直接闭合供区。
预扩张带蒂 TDA 穿支皮瓣是松解烧伤挛缩后腋窝缺损覆盖的一种合适选择。可以获得柔软的质地和较大尺寸的皮瓣来转移到腋窝区域，供区瘢痕被认为是可接受的美容效果。
