Treatment of axillary burn scar contracture using opposite running Y-V-plasty

Burn scar contractures are frequently observed following full-thickness burns of the axillary area. Such contractures are traditionally reconstructed sometime within the first year after injury with therapeutic methods including skin grafting, Z-plasty, local/regional flap, island flap, perforator flap, free flap or combination thereof. Flap methods have many advantages over split skin grafting, including less likelihood of recurrence of contracture as well as making prolonged splinting unnecessary. However these flaps are cumbersome, unattractive, and apparently distort the axillary hair. Moreover, they have a risk of flap necrosis or marginal vascular compromise. A new opposite running Y-V-plasty presented here is designed to overcome those dilemmas. This procedure was performed in eight cases with good functional recovery and cosmetic appearance. It is also a simple, adaptable, and reliable method. The range of motion of shoulder joint was also satisfactorily achieved since axillary contracture scars were almost completely released. Most of all the procedure can be repeated if the release is not enough. In short, the opposite running Y-V-plasty is a good alternative method when we consider the reconstruction of axillary burn contracture.