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PubMedDate not supplied

A systematic approach to flap selection for the axillary burn contracture.

Any soft-tissue deficiency about the axilla unfortunately may readily be translated into a functional limitation of the upper extremity that should be addressed in a simple yet expeditious fashion. Commonly a sequela of burn injuries, significant skin destruction in kind must be restored. Whatever the etiology of major deformities, the vital axillary structures and preservation of shoulder range of motion may best be accomplished by resurfacing with the use of vascularized tissues taken from sources adjacent to the defect. If this is the case, the efficacious application of these local muscle or fascial flaps mandates a realization that such choices are finite in number. A schema for a reasonable flap selection process has been devised based on the relative severity and anatomic location of the axillary burn scar contracture.

Axilla↗
PubMedDate not supplied

Dupuytren's contracture after burns of the upper extremity.

A case of Dupuytren's contracture in a patient with previous history of burns of the upper extremity is reported. Because this patient has no predisposition to the disease, burns of the upper extremity should be considered as a trigger to the onset of the disease.

Arm Injuries↗
PubMed1976

Histological investigation of the etiology of capsule contracture following augmentation mammaplasty.

Sections obtained from contracted breast capsules were examined by light and electron microscopy. We observed the presence of multiple areas of a particulate foreign material, consistent with the appearance of droplets of dimethylpolysiloxane. An active foreign-body reaction was observed at the interface of the capsule and implant, as well as throughout the tissue subjacent to the deposits of foreign material. Based on these histological observations, we present a theoretical explanation of the etiology of capsular contracture of the breast after augmentation mammaplasty.

Adult↗
PubMed1978

Ten years of experience in managing patients with burn contractures of axilla, elbow, wrist, and knee joints.

An analysis of 625 patients who had sustained burns across the axillae, elbows, wrists, or knee joints indicates that the use of splints and pressure across these joints will not only greatly decrease the incidence of contractures but will also reduce the frequency and need for release operations. However, these appliances must be used for at least 6 months (longer, if possible), if substantial benefits are to be obtained.

Axilla↗
PubMed1981

Surgical correction of postburn flexion contractures of the fingers in children.

One-hundred forty-eight operative procedures for flexion contractures of the finger(s) following burn injury in children have been studied in detail with follow-up from 6 months to 8 years. Intramedullary K-wires, used for 53 procedures where a graft was done, were associated with a significantly worse long-term result, and graft take was not improved by using K-wires. Length of time between burn injury and reconstruction, age at time of operation, the use of full-thickness versus partial-thickness grafts, and the digit involved had an apparent effect on final result. The use of postoperative topical steroids could not be evaluated adequately in this study. The preferred operative techniques for this condition are discussed.

Bandages↗
PubMed1983

Adjustable dynamic external splint for control of first web contracture.

A method is presented to overcome problems of first web space contracture by means of a dynamic, continuously adjustable, wedge-shaped splint. The device is easily constructed of inexpensive material by physician or hand therapist. The splint is custom-tailored to the individual patient and is lightweight and comfortable, promoting good patient compliance. Its continuously adjustable nature maximizes its effects throughout therapy, and the even distribution of the pressure makes for a high surface area of patient/splint contact for even pressure distribution and eliminates the problems of skin necrosis, even with lengthy applications.

Contracture↗
PubMed1984

The use of a buried wire frame to reduce contracture of grafts.

Contracture following the successful take of a split-thickness cutaneous graft may be difficult to avoid if a force opposite to the contraction cannot be applied. In this paper, a procedure is described in which a wire-frame buried around the graft maintains it expanded during the contractile period.

Adolescent↗
PubMed1985

Inverted-U parascapular flap for the treatment of axillary burn scar contracture.

In this paper we report the technique of using an inverted-U parascapular flap for treating axillary scar contracture. The advantages of using this inverted-U flap are that it is possible to close the donor site by primary suturing, it is possible to cover a large skin defect, and it is possible to construct either a cavity or a swelling in the skin-defect region.

Burns↗
PubMed1989

Bilobed flap in the release of postburn mentosternal contracture.

We have described in brief detail our experience with bilobed flaps in the release of postburn mentosternal synaechia. We have found this method handy, and it gives very good results. We reckon that this method has a prominent place in the release of this contracture, particularly in children who cannot provide adequate free-skin flaps for revascularization and in centers where the procedure is technically impossible.

Adult↗
PubMed1990

Application of the two-flap method for nasal alar contracture.

Reconstruction of the contracted nasal ala has been a very difficult problem for plastic surgeons. Numerous surgical procedures have been reported. However, most operations require multiple stages and leave conspicuous facial scarring and a thick, asymmetrical nostril rim. We have used the two-flap method introduced by Thomson and Sleightholm for isolated naso-ocular clefts, but we have added some modifications to this method: making a deeper backcut into the dome on the mesial side of the contracture and using thinner flaps than were originally used. As a result, we have achieved reasonable symmetry, good color match, appropriate thickness, and no conspicuous facial scarring in every patient.

Contracture↗
PubMed1995

Superior extension of the parascapular free flap for cervical burn scar contracture.

A newly designed superior extension of the parascapular free flap and its free transfer clinically for the repair of 11 cases of cervical burn scar contracture without any loss are presented. The flap sizes ranged from 16 x 7 cm to 32 x 11 cm. Based on the anatomic distribution of the circumflex scapular vessels, the flap in the scapular territory can be taken much longer and wider than before. There is less tension in this vertically oriented flap than in the horizontally oriented flap in obtaining primary closure. This method extends the application of the scapular territory as a donor site for free flaps.

Adolescent↗
PubMed2002

Use of free thin anterolateral thigh flaps combined with cervicoplasty for reconstruction of postburn anterior cervical contractures.

Free thin anterolateral thigh flaps combined with cervicoplasty were used in a series of seven patients undergoing reconstruction for previous burn injury from September of 2000 to May of 2001 at Chang Gung Memorial Hospital. This method uses a suprafascial dissection technique to provide a thin flap to improve cervical contour. Neck contractures had resulted from flame burns in six patients and from a chemical burn in one patient. The mean age was 32.7 years (range, 22 to 45 years). The size of excised scar ranged from 10 x 2 cm to 26 x 5 cm (mean, 19.7 x 3.3 cm). The size of flaps ranged from 11 x 5 cm to 26 x 8 cm (mean, 21.3 x 6.5 cm). Average operative time was 6 hours. Average hospital stay was 10 days. All flaps survived, with one flap sustaining partial marginal loss. The donor site was closed primarily in five cases and by using a split-thickness skin graft in two cases. At a mean follow-up time of 5 months, the functional improvement was measured as follows: a mean increase in extension of 30 degrees (preoperatively, 95 degrees; postoperatively, 125 degrees), a mean increase in rotation of 18 degrees (preoperatively, 59 degrees; postoperatively, 77 degrees), and a mean increase in lateral flexion of 12.5 degrees (preoperatively, 26.5 degrees; postoperatively, 39 degrees). The average cervicomandibular angle was improved by 25 degrees (preoperatively, 145 degrees; postoperatively, 120 degrees). This series demonstrates that the use of free thin anterolateral thigh flaps combined with cervicoplasty provides a one-stage reconstruction with a thin, pliable flap that achieves good cervical contour with low donor-site morbidity.

Adult↗
PubMed1985

Cardiac defects in a patient with congenital contractural arachnodactyly.

Congenital contractural arachnodactyly (CCA) is a connective tissue disorder sharing many of the clinical manifestations of Marfan's syndrome. The case presented emphasizes that severe cardiac involvement may be manifested in the neonate with CCA, thus altering the more characteristic benign prognosis of CCA.

Contracture↗
PubMed1986

Tissue expansion in the treatment of hypertrophic scars and scar contractures.

The temporary tissue expander can generate an excess of full-thickness skin that can be recruited into an adjacent area of tissue deficiency caused by scar contracture. The creation of a pseudobursa enhances the functional improvement gained by this technique. Now in its developmental stage, tissue expansion carries an alarming complication rate (33%), but we expect refinements in technique to diminish this percentage.

Adult↗
PubMed1996

Reflex hyperexcitability and muscle contracture in relation to spastic hypertonia.

Mechanisms of spasticity and possible therapeutic interventions continue to dominate research into motor disorders following cerebral lesions. However, the accumulated evidence suggests that this focus on spasticity may be out of step with its effects. In contrast, hypertonia remains an important problem. Further investigation into its link with muscle contracture is required and it needs to be clearly distinguished from reflex hyperexcitability in patients with spasticity.

Brain Damage, Chronic↗