A nonhealing, irradiated axillary wound was closed with an ipsilateral biceps brachii muscle flap covered with a full-thickness skin graft. This patient's surgical options were limited by a compromised blood supply to the traditional muscle flaps of the subscapular artery axis and radiation vasculitis of the surrounding tissues. In addition, brachial plexopathy and functional loss of the upper extremity provided expendable soft-tissue alternatives for muscle flaps. The specific anatomy of, the indications for use, and harvest of a biceps brachii muscle flap are presented. In the setting of a nonfunctional upper extremity or impending limb loss, the biceps brachii muscle flap offers excellent coverage of proximal upper extremity or axillary wounds with minimal donor site morbidity.
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