title: Surgical repair for macrostomia: significance of Z-plasty limb directions.
abstract: The objective of this study was to determine whether the direction of Z-plasty limbs incorporated into the surgical repair for macrostomia had a significant influence on the quality of the resultant scar. A total of 41 patients who underwent macrostomia repair by means of the same technique, and who had a follow up period of at least 2 years, were retrospectively reviewed through postoperative photographs and medical records. Quality of scar, lip symmetry, and commissure shape and thickness were recorded. Our results showed that a more favorable scar would be achieved in the medial limb of the Z-plasty if it was planned parallel to relaxed skin tension lines (P < 0.05). An unfavorable scar would be more likely if the medial limb of the Z-plasty was made in a horizontal direction or perpendicular to relaxed skin tension lines (P < 0.05). The quality of scar in both the central and lateral limbs of the Z-plasty was not significantly influenced by their direction.
authors.affiliation: Craniofacial Centre, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
authors.forename: Chung-Chih
authors.initials: CC
authors.lastname: Yu
authors.forename: Raymond C W
authors.initials: RC
authors.lastname: Goh
authors.forename: Lun-Jou
authors.initials: LJ
authors.lastname: Lo
authors.forename: Philip K T
authors.initials: PK
authors.lastname: Chen
authors.forename: Yu-Ray
authors.initials: YR
authors.lastname: Chen
mesh_terms: D002921:Cicatrix / Q000517:prevention & control; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D008265:Macrostomia / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011336:Probability; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013524:Surgical Flaps; D013536:Suture Techniques