title: Double combined Z-plasty for wide-scar contracture release.
abstract: Z-plasty is one of the most widely employed techniques in plastic surgery and mainly serves the following purposes: elongation along the axis of the scar, dispersal of the scar followed by breaking up the straight-line scar and realigning the scar within the lines of minimal tension. It is useful especially to release linear-scar contracture, yet difficult for wide scars. This report describes a novel technique to release contracture effectively for any wide scars using a new design called double combined Z-plasty. The design is simple. The main limb is set to incise the wide scar, and this main limb is shared as a peripheral limb by two other Z-plasty designs. From the main limb, each central limb is designed along the margin of the scar in the opposite direction. The main and central limbs have 90° between them. Other peripheral limbs are then designed facing laterally to the intact skin to make 60° for the central limb. After skin incision, two triangular intact skin flaps could be inserted into the wide scar from both sides, making it possible to release contracture. We performed this technique on eight patients. All wounds healed well and scar contracture was satisfactorily released. This procedure is very useful for wide-scar contracture, compared to conventional Z-plasty.
authors: Department of Plastic and Reconstructive Surgery, Sapporo Medical University School of Medicine, S1W16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. yotsuyanagi@sapmed.ac.jp
authors: Takatoshi
authors: T
authors: Yotsuyanagi
authors: Ken
authors: K
authors: Yamashita
authors: Ayako
authors: A
authors: Gonda
authors: Shinji
authors: S
authors: Kato
authors: Asuka
authors: A
authors: Sugai
authors: Tetsuo
authors: T
authors: Yamada
authors: Musashi
authors: M
authors: Kayama
authors: Kanae
authors: K
authors: Ikeda
authors: Makoto
authors: M
authors: Yamauchi
authors: Tamotsu
authors: T
authors: Saito
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002921:Cicatrix / Q000150:complications / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000150:complications / Q000601:surgery*; D013524:Surgical Flaps; D055815:Young Adult