Use of pectoralis major perforators for local "free-style" perforator flap in axillary reconstruction: a case report.

Axillary scar contracture in a previously poly-traumatized present a challenging task for a reconstructive surgeon from the functional and esthetic standpoint. While harvest of local myocutaneous flaps will obviously contribute to further limitation of arm movements in already functionally impaired shoulder, pedicled perforator flaps from the lateral and posterior thoracic region may not be available due to extensive scarring after high-energy trauma with soft-tissue loss. We present a new perforator pedicled flap, designed, and harvested exclusively on the basis of "free style perforator flap" concept, based on the perforators coming from the pectoral region. The operative technique and outcome are discussed in this report. Copyright 2009 Wiley-Liss, Inc. Microsurgery, 2010.