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ORIGINAL ARTICLE
Year : 2012  |  Volume : 20  |  Issue : 1  |  Page : 23-29

Management of post burn axillary contracture along with breast contracture: Our experience


Department of Plastic Surgery, Gauhati Medical College, Guwahati, Assam, India

Correspondence Address:
Seema Rekha Devi
Department of Plastic Surgery, Gauhati Medical College, Guwahati, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-653X.111776

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Background: Post burn axillary contracture along with breast contracture is a challenging problem to the reconstructive surgeon. Most often both types co-exist. The goal is to achieve full functional range of movement of shoulder with reconstruction of the aesthetic breast unit. Materials and Methods: This is a retrospective hospital based study of 15 patients, conducted over a period of 1 year from Aug 2009 to Sept 2010. All the patients in this study were prepubertal and postpubertal females of ages ranging from 13 years to 36 years and having post burn contractures of the axilla with involvement of breast. Axillary and breast release was done in the same sitting in all the cases. Axillary contracture was released followed by split skin graft (SSG) and/or with different types of flaps including propeller flap, along with release of breast mound to its proper size and shape to match the opposite breast. Raw areas were covered with radially placed medium thickness split skin graft around the nipple areolar complex (NAC). Assessment was done on the basis of functional and aesthetic outcome. Results: Out of 15 cases, 10 cases were of type 3 axillary burn contracture with breast contracture of moderate degree in severity. The abduction angle achieved post-operatively was >90 degrees in 14 out of 15 cases. The patients were assessed on the basis of patient satisfaction, size and shape of the axilla and the breast and position of the NAC from defined landmarks. It was found to be aesthetically fair in 9 cases, good in 5 cases and excellent in 1 case.


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