To summarize the clinical experience of circumflex scapular artery perforator flap in functional reconstruction of severe axillary cicatricial contracture after burn.

From January 2015 to June 2023, 38 patients with severe post-burn axillary cicatricial contracture were treated in Department of Burns, Beijing Jishuitan Hospital, Capital Medical University, including 25 males and 13 females aged 5 to 48 years. The joint abduction angle of the affected shoulder ranged from 20° to 70° before surgery. There were 29 cases of unilateral axillary cicatricial contracture and 9 cases of bilateral axillary cicatricial contracture. Surgical cicatricial contracture release was performed, and functional reconstruction and repair was performed with circumflex scapular artery perforator flap, including one scapular flap with blood supply from the transverse branch of circumflex scapular artery, 34 parascapular flaps with blood supply from the descending branch, and 12 scapular bilobate flaps with transverse branch and descending branch. The Constant-Murley score and Neer score were used to evaluate the range of motion and function of the shoulder joint in patients before surgery and at 2 weeks and 6 months after surgery.

The range of motion and function of the shoulder joint significantly improved after surgery in 38 patients. Before surgery and at 2 weeks and 6 months after surgery, the Constant Murley scores was (14.28 ± 8.15), (41.17 ± 9.17) and (39.37 ± 11.47) respectively; the Neer scores was (12.58 ± 7.25), (39.67 ± 9.87) and (37.39 ± 12.48) respectively. The shoulder joint mobility was improved, and the joint abduction angle were all larger than 90°. There was no axillary cicatricial contracture recurrence in all patients.

The effect of circumflex scapular artery perforator flap for functional repair of axillary cicatricial contracture deformity is good, with little damage in donor area.