[Treatment of axillary burn scars by a scapular island flap with a vascular pedicle]

Type 3 axillary burn retractions, involving the neck, the axilla, the upper arm and the lateral aspect of the chest, can cause difficult static and dynamic deficits altering the aesthetic appearance and the function of the shoulder. The posterior scapular area can provide an autonomized skin flap, based on the circumflex scapular vessels. This scapular flap, used as an island vascular flap, easily covers the anterior and posterior aspects of the axilla, obtaining a smooth skin surface, with a good underlying subcutaneous fatty tissue. Its elastic properties are well adapted to the dynamic requirements of the separate movements of the shoulder joint. Performed on 25 axillary burn retractions in 20 patients, this flap provided a convincing improvement in the shoulder range of movement and a return to a normal activity.