Dressing of the Axilla Using a Water-Filled Surgical Glove After Axilla Grafting
Usually, after grafting of the axilla, it is difficult to obtain a reliable dressing using traditional materials including tulls and fluffy gauzes. As an alternative to this traditional approach, a sterile surgical glove filled with saline can be used to obtain a bulky dressing.
Classification and surgical correction of postburn axillary contractures.
Postburn axillary contractures should be surgically corrected as soon as the diagnosis has been established in order to avoid deeper tissue involvement. We have classified axillary contractures based upon local anatomic conditions and present procedures for correction of each type that we find most suitable. Type I contractures are characterized by a linear web at either axillary fold with minimal adjacent scarring. A double Z-plasty with Y-V advancement is the procedure of choice. Type II contractures involve either axillary fold, with adjacent skin scarring. A double incisional release on both sides of the hair-bearing area is the procedure of choice. Type III contractures are characterized by linear webs at both axillary folds without involvement of the adjacent skin. The procedure of choice in these cases is a double incisional release. Type IV axillary contractures involve the hair-bearing area and the periaxillary region. This diffuse scar contracture is best treated by a single incisional release.
The Posterior Interosseous Forearm Island Flap for Skin Defects in the Hand and Elbow
The authors’ experience of 51 posterior interosseous forearm island flaps is presented. Its main indications were inadequate scar or scar contraction and complex trauma with gross skin loss, either acute or postprimary. The flap healed uneventfully in 45 cases (88%), but in six it was partially or subtotally lost due to necrosis. Late complications included hair growth in the first web and palm, flap redundancy and hypertrophic scar at the donor site. The posterior interosseous island flap produces excellent skin coverage but is difficult to raise and tends to develop oedema and occasionally necrosis.