A systematic approach to flap selection for the axillary burn contracture.

Any soft-tissue deficiency about the axilla unfortunately may readily be translated into a functional limitation of the upper extremity that should be addressed in a simple yet expeditious fashion. Commonly a sequela of burn injuries, significant skin destruction in kind must be restored. Whatever the etiology of major deformities, the vital axillary structures and preservation of shoulder range of motion may best be accomplished by resurfacing with the use of vascularized tissues taken from sources adjacent to the defect. If this is the case, the efficacious application of these local muscle or fascial flaps mandates a realization that such choices are finite in number. A schema for a reasonable flap selection process has been devised based on the relative severity and anatomic location of the axillary burn scar contracture.