title: Pre-expanded pedicled thoracodorsal artery perforator flap for postburn axillary contracture reconstruction.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey. yakulahci@yahoo.com
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Kulahci
authors.forename: Celalettin
authors.initials: C
authors.lastname: Sever
authors.forename: Fatih
authors.initials: F
authors.lastname: Uygur
authors.forename: Sinan
authors.initials: S
authors.lastname: Oksuz
authors.forename: Cihan
authors.initials: C
authors.lastname: Sahin
authors.forename: Haluk
authors.initials: H
authors.lastname: Duman
mesh_terms: D000328:Adult; D001365:Axilla / Q000293:injuries*; D002056:Burns / Q000150:complications* / Q000601:surgery; D003286:Contracture / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology; D013524:Surgical Flaps / Q000098:blood supply; D055815:Young Adult