Latissimus Dorsi Myocutaneous Flap Reconstruction of Neck and Axillary Burn Contractures

• Published in: Plastic and reconstructive surgery (1963) Vol. 105; no. 1; pp. 27 - 33
• Main Authors: Wilson, Ian F, Lokeh, Adam, Schubert, Warren, Benjamin, Charles I
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Society of Plastic Surgeons 01-01-2000; Lippincott Williams & Wilkins
• Subjects: Adult; Axilla - injuries; Axilla - surgery; Biological and medical sciences; Burns; Burns - surgery; Child; Child, Preschool; Cicatrix, Hypertrophic - surgery; Contracture - surgery; Developing Countries; Esthetics; Female; Follow-Up Studies; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Medical sciences; Neck Injuries - surgery; Reoperation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Surgical Flaps; Suture Techniques; Traumas. Diseases due to physical agents; Treatment Outcome; Human; Skin disease; Male; Latissimus dorsi muscle; Trauma; Contracture; Result; Burn; Case study; Plasty; Treatment; Surgery; ENT disease; Adult; Complication; Female; Musculocutaneous flap; Neck; Technique; Child; Axillary
• ISSN: 0032-1052; 1529-4242
• DOI: 10.1097/00006534-200001000-00005

Neck and axillary burn contractures are both a devastating functional and cosmetic deformity for patients and a challenging problem for reconstructive surgeons. Severe contractures are more commonly seen in the developing world, a result of both the widespread use of open fires and the inadequacy of primary and secondary burn care in these vicinities. When deep burns are allowed to heal spontaneously, patients develop hypertrophic scarring of the neck and axillary areas. The back is typically spared, however, remaining a suitable donor site.We have used nine latissimus dorsi myocutaneous flaps in a total of six patients, finding the flaps effective in resurfacing both the neck and the axillary regions after wide release of burn contractures. Before flap mobilization, surgical neck release is often necessary to ensure safe, effective control of the airway in patients with significant neck contractures. Flap bulkiness in the anterior neck region can eventually be reduced by dividing the thoracodorsal nerve. Anchoring the skin paddle to its recipient site through the placement of tacking sutures will also help achieve a more normal anterior neck contour. (Plast. Reconstr. Surg. 10527, 2000.)