29 巻 (2016) 3 号 p. 156-160
Burn contractures of the elbow joint can cause severe dysfunction. Such contractures are difficult to treat, as they result in the formation of cicatricial tissue and an insufficient blood supply. Many surgical techniques for treating burn contractures, including Z-plasties, skin grafting, and flap transfers, have been described. Reconstruction using a free flap makes it possible to improve severe and wide contractures. However, secondary operations are often required to revise bulky flaps. Here, we describe the case of a 28-year-old male with severe burn contractures of the bilateral upper extremities. After releasing the contracture using the bilateral Y-shaped incision technique, a free flap transfer was performed using thin superficial circumflex iliac artery perforator ( SCIP ) flaps ( thin-SCIP flap ). After surgery, the range of motion of the affected joints was markedly increased, and the patient was soon able to return to social activities and did not suffer any re-contracture. The thin-SCIP flap can be safely elevated above the superficial fascia and dissected under a microscope. It makes it possible to achieve one-stage reconstruction, provides elastic motion, and reduces the risk of re-contracture.