Surgical treatment of severe or moderate axillary burn scar contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients—A clinical experience of 15 cases

Chen, Baoguo; Xu, Min; Chai, Jiake; Song, Haixing; Gao, Quanwen

doi:10.1016/j.burns.2014.10.029

Cited by 16 publications

(10 citation statements)

References 14 publications

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“…Thus, scars across the joints may lead to dysfunction of the joints [ 9 ]. In the past, the dysfunction caused by scars often went unaddressed until the scars matured or caused severe dysfunction, at which time they were treated surgically [ 32 ]. Nevertheless, after extensive burn trauma, the body’s skin/flap supply area is limited even when dilators are used.…”

Section: Discussionmentioning

confidence: 99%

Effects of multiple modes of UltraPulse fractional CO2 laser treatment on extensive scarring: a retrospective study

Sun

Lin

et al. 2021

Lasers Med Sci

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The main therapeutic options for extensive scarring (e.g., > 20% of the total body surface area, or TBSA) after burns and trauma have focused on conservative treatments, such as compression, moisturization, and topical agent application. However, these treatments may not achieve optimal effects due to the large size and complexity of the scars. UltraPulse fractional CO2 laser treatment is a novel approach that is currently a subject of intense interest; this treatment is most widely used to improve texture, pliability, and pigmentation in all types of scars. However, no studies on the independent use of UltraPulse fractional CO2 laser treatment for extensive scars have been reported. This retrospective study evaluated a total of 21 patients, whose scars covered 20 to 65% TBSA. Scar thickness was measured by ultrasonography before treatment. Personalized treatment modalities and parameters were set according to the scar type and thickness. Scar formation and treatment effects were evaluated by photography, the Patient and Observer Scar Assessment Scale (POSAS), and patients’ judgment of effectiveness. Where the scars covered joints, joint function was assessed by measuring the maximum range of motion (ROM). With laser therapy, scars became flatter and lighter; furthermore, pruritus, pain, and discomfort decreased significantly. POSAS scores significantly decreased after laser therapy, including the item scores for pain and pruritus. There were no instances of joint contracture, ROM reduction, apparent functional impairment, serious adverse events, or comorbidities. This study demonstrates the safety and efficiency of UltraPulse fractional CO2 laser treatment for extensive scarring.

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Section: Discussionmentioning

confidence: 99%

Effects of multiple modes of UltraPulse fractional CO2 laser treatment on extensive scarring: a retrospective study

Sun

Lin

et al. 2021

Lasers Med Sci

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“…Combined operation of skin graft and flap utility may be helpful in releasing a scar or removing a scar completely if the condition is permitted. It may minimise the number of re‐operations to some extent, although there are published articles about scar contracture using single flaps in some areas …”

Section: Discussionmentioning

confidence: 99%

“…It may minimise the number of re-operations to some extent, although there are published articles about scar contracture using single flaps in some areas. 13,14 4.4 | Anti-scar treatment…”

Section: Scar Size and Combined Operative Methodsmentioning

confidence: 99%

Statistical analysis of factors affecting re‐operative times in paediatric patients with scar deformity after deep second‐degree burn injury

Chen¹,

Yue²,

Zhang³

et al. 2018

International Wound Journal

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Deep second-degree burn injuries pose a challenge for treating scar deformity in developing paediatric patients. Some patients underwent several re-operations during their development. There was no literature reporting which factors affect re-operative times. In this article, we intend to analyse possible influential factors that are responsible for re-operative times in paediatric patients with scar deformity after deep second-degree burn injuries. From 2010 to 2016, 177 paediatric cases with a history of deep second-degree burn injury who underwent re-operation once, twice, and equal to or more than thrice were recruited to this study, with age ranging from 0 to 18 years. The following factors were analysed: age, gender, size of scar, method for reconstruction, location, postoperative anti-scar treatment, preschool group, school group, combined deformity, and combined method for reconstruction. One-way ANOVA and multi-way ANOVA analysis were used as statistical tools to analyse the above factors and re-operative times. There were 83 male cases and 94 female cases, with an average age of 7.47 years. Statistical significance was achieved for the size of scar (P = 0.000), operation method (P = 0.001), and combined deformity (P = 0.026) under 1-way ANOVA in different re-operative times. The operation methods for the head and neck area (P < 0.05) and the lower extremities (P < 0.05) are critical factors for multi-factor variance analysis in different re-operative times. Multivariate logistic regression analysis also demonstrated that the size of scar was an independent risk factor for the number of operations. Combined operative method was a protective risk factor for the number of operations. There was no statistical significance obtained for other factors. Size of scar, operation method, and combined operation method are the risk factors for re-operative times, while operation methods for the head and neck area and lower extremities are the critical factors for re-operative times. We can use the combined method to resolve scar-related problems in order to reduce re-operative times.

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“…The horizontal branch of circumflex scapular artery is the nutrient vessel of the flap. Scapular flap could be executed as a local flap (6) or a free flap (7) or even as a pre-expanded flap (8) according to the requirements. It is best known with the thin and pliable skin that is an ideal structure for the axilla.…”

Section: Introductionmentioning

confidence: 99%

Scapular Island Flap as a Workhorse Flap for Axillary Defect Reconstruction

Altiparmak

2020

std

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Amaç: Aksiller defektler genellikle yanık kontraktürlerinin açılması veya hidradenitis suppurativa debridmanlarının neticesinde meydana gelir. Onarımdaki nihai hedef, omuz ekleminde tam hareketlilik sağlayan ince ve esnek bir kapama olması nedeniyle zordur. Aksiller defekt onarım seçeneklerinden birisi skapuler fleptir. Bu çalışmanın amacı skapuler ada fleplerinin aksiller defektlerin onarımında farklı endikasyonlardaki kullanımını sunmak, onarım sonuçlarını değerlendirmek ve aksiller rekonstrüksiyonda skapuler ada flebinin ana flep olarak tartışılmaktır. Hastalar ve Yöntem: Retrospektif olarak 2015 ile 2019 yılları arasında yapılan toplam 7 hastada 8 skapuler ada flebi çalışmaya dahil edildi. Beş hasta hidradenit nedeniyle opere edilirken 2 hasta ise aksiller kontraktür nedeniyle rekonstrükte edildi. Tüm skapüler fleplerin pedikülleri iskeletize edildi ve trianguler aralıktan aksiller bölgeye aktarıldı. Bulgular: Flep boyutları 84cm2 ile 128 cm2 arasında değişmekte ve genişliği en fazla 8cm'e kadar ulaşmaktaydı. Donör alan skarları 3 ile 6 ay arasında yaştan bağımsız olarak genişledi. En az 3 aylık takiplerde donör alan skarları 1,5 ile 2,6 cm arasında değişiklik gösterdi. Bir tanesi hariç (sekonder iyileşen tip nekrozu) tüm flepler komplikasyonsuz sonuçlandı. Sonuç: Skapuler ada flebi çeşitli nedenlerden dolayı oluşan aksiller defektlerin onarımında kullanılabilir. Flebin yatay uzanıma sahip olması posterior aksiller çizgideki ve koldaki yanık alanlarından bağımsız hareket edebilmesini sağlar. Skarların genişlemesi bir dezavantaj olarak görülse de, skapuler flebin ince ve esnek kapama sağlaması, kolay elevasyonu ve komplikasyon oranının düşük olması nedeniyle aksiller rekonstrüksiyonunun ana flebi olarak değerlendirilebilir.

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Surgical treatment of severe or moderate axillary burn scar contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients—A clinical experience of 15 cases

Cited by 16 publications

References 14 publications

Effects of multiple modes of UltraPulse fractional CO2 laser treatment on extensive scarring: a retrospective study

Effects of multiple modes of UltraPulse fractional CO2 laser treatment on extensive scarring: a retrospective study

Statistical analysis of factors affecting re‐operative times in paediatric patients with scar deformity after deep second‐degree burn injury

Scapular Island Flap as a Workhorse Flap for Axillary Defect Reconstruction

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