The Application Of Five Falp Z-plasty With The Fasciocutaneous Scar Skin Flap In Reconstructing Webbed Cicatricial Contracture Deformity Of Axilla

Objective Through probing the characteristic of five flap Z-plasty with the blood supply of the fasciocutaneous scar skin flap,to provide the basis for the clinical application of correction webbed cicatricial contracture deformity of axilla with five flap Z-plasty with the fasciocutaneous scar skin flap.Methods To review local anatomical structure of axilla.The clinical study included 19 patients(13 males and 6 females)in a 2-year period,the patients ranged in age from 3 to 29 years with a mean age of 13 years.19 patients suffered webbed cicatricial contracture deformity of axilla after deep burn wound were treated with five flap Z-plasty with the fasciocutaneous scar skin flap.Compare the axial length of webbed cicatricial contracture of axilla respectively around operations,still including the angle varity of flexion,abduction and raising of the shoulder joint,calculate the extention rate of the axial length of webbed cicatricial contracture of axilla. The survival rate of the fasciocutaneous scar skin flap,aesthetic and functional outcomes of the reconstructed axilla were followed up.To slice some tissue on the point of fasciocutaneous scar skin flaps,the tissue carring fasciocutaneous and fat.The tissue was fixed in 10% formalin, then to make sections form of Pathological organization.To observe perforators of blood vessel on horizontal fault and describe the formation of perforators of blood vessel by microscope.Result After 19 patients suffered webbed cicatricial contracture deformity of axilla after deep burn wound underwent operation, webbed cicatricial contracture was loosen obviously, the average extention rate of webbed cicatricial contracture of axilla is 74.8%.All fasciocutaneous scar skin flaps survived satisfactorily, but fasciocutaneous scar skin flaps of 8 patients had the blister on the points,which healed spontaneously by changing fresh dressing. During 3-6 months of clinical follow-up after the operation,the aesthetic and functional results of each case were satisfactory by patients and surgeon. To observe perforators of blood vessel on horizontal fault by microscope, plenty of perforators of blood vessel can be seen which supply abundant blood for scar flap.Conclusions Fasciocutaneous scar skin flaps have abundant blood because vescular network of its surface has a lot of perforators that supply blood upward. Five flap Z-plasty with the fasciocutaneous scar skin flap is ideally suitable for the reconstruction of deformity of axilla, provides anexcellent choice for cosmetic and functional reconstruction of the deformity.It is simple,dependable and easy to harvest flap that can repair webbed cicatricial contracture deformity of axilla.