WordNet

the 26th letter of the Roman alphabet; "the British call Z zed and the Scots call it ezed but Americans call it zee"; "he doesnt know A from izzard" (同)z, zee, zed, ezed, izzard

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2018/03/19 18:53:04」(JST)

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Diagram of a Z-plasty procedure.

Z-plasty is a versatile plastic surgery technique that is used to improve the functional and cosmetic appearance of scars. It can elongate a contracted scar or rotate the scar tension line. The middle line of the Z-shaped incision (the central element) is made along the line of greatest tension or contraction, and triangular flaps are raised on opposite sides of the two ends and then transposed. The length and angle of each flap are usually the same to avoid mismatched flaps that may be difficult to close. Some possible complications of Z-plasty include flap necrosis, haematoma (blood clot) formation under the flaps, wound infection, trapdoor effect and sloughing (necrosis) of the flap caused by wound tension and inadequate blood supply.

Classification

Z-plasties can be functional (elongate and relax scars) or cosmetic (realign scars to make them less noticeable). They can be single or multiple. Variations include skew and planimetric Z-plasties.

Technique

The transposition of two triangular flaps. The incisions are designed to create a Z shape with the central limb aligned with the part of the scar that needs lengthening or re-aligning. The traditional 60° angle Z-plasty will give a theoretical lengthening of the central limb of 75%.^[1] Single or multiple z-plasties can be used. Specific modifications include the double-opposing z-plasty (sometimes called a "jumping man" flap) which can be useful for release of webbing of the medial canthus or release of 1st web space contractures. It is one of the techniques used in scar revision, especially in burn scar contracture.

Functional Z-plasty

Z plasty procedure to release palmar contracture.

The lengthening of a scar. Used to help relax or release linear burn scar contractures. The technique is dependent on the availability of mobile adjacent skin.

Cosmetic Z-plasty

The irregularisation of a scar to make it less noticeable. Re-alignment of the central element can place the scar in natural skin tension lines and thereby disguise it. One of a family of similar techniques (such a W plasty).

History

The first Z-plasty was performed by Horner in 1837, followed by Denonvilliers in 1854, both for correction of ectropion.^[2] The first standard double transposition Z-plasty was reported by Berger in 1904, and McCurdy introduced the term in 1913.

References

^ Z-Plasty~treatment at eMedicine
^ Borges, A. F. (July 1973). "The original Z-plasty". British Journal of Plastic Surgery. 26 (3): 237–246. doi:10.1016/0007-1226(73)90008-8. PMID 4580014.

External links

eMedicine: Z-plasty
eMedicine: Z-plasty images

UpToDate Contents

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1. Z形成術 z plasty
2. 熱傷再建の原理：会陰および生殖器 principles of burn reconstruction perineum and genitalia
3. 再建術のためのグラフトおよび弁の原理 principles of grafts and flaps for reconstructive surgery
4. 熱傷再建の原則：四肢および所属リンパ節領域 principles of burn reconstruction extremities and regional nodal basins
5. 熱傷再建の原則：顔面、頭皮、および頸部 principles of burn reconstruction face scalp and neck

English Journal

Postinfective skin contracture: a rare cause of fifth metatarsophalangeal joint subluxation.

Prakash J, Mehtani A.
BMJ case reports.BMJ Case Rep.2014 Sep 8;2014. pii: bcr2014206176. doi: 10.1136/bcr-2014-206176.
Dislocation or subluxation of the metatarsophalangeal joint (MTP) is common and usually follows a traumatic event. Non-traumatic causes usually include inflammatory arthritis (rheumatoid arthritis), connective tissue disorders, crowded shoewear or flexor digitorum longus tendon contracture. We prese
PMID 25199201

Influence of Modified Furlow Double Opposing Z-plasty on Mandibular Growth in Oriental Patients With Cleft Palate and/or Lip.

Kim S1, Choi TH, Park JU, Kwon G, Kim JC.
Annals of plastic surgery.Ann Plast Surg.2014 Sep;73(3):311-4. doi: 10.1097/SAP.0b013e31827aeb6c.
The purpose of this study was to statistically analyze mandibular growth disturbance in the Oriental cleft population and compare this with that of non-cleft children through cephalometric analysis. Thirty-six children with cleft palates, repaired using a modification of Furlow double opposing Z-pla
PMID 24374402

Reversed Z-plasty and its variations to release wide-scar contraction.

Zhang L, Jin R, Shi YM, Sun BS, Pu ZM, Zhang YG.
Burns : journal of the International Society for Burn Injuries.Burns.2014 Sep;40(6):1185-8. doi: 10.1016/j.burns.2013.12.016. Epub 2014 Jan 28.
BACKGROUND AND AIM: Z-plasty is one of the most widely used techniques in plastic and reconstructive surgery. It is useful especially to release linear-scar contractures, yet difficult to use for wide scars. The aim of this study was to report on a new technique for the effective release of contract
PMID 24484916

Japanese Journal

手・上肢の瘢痕拘縮に対する治療 (特集手・上肢の組織損傷・欠損治療マニュアル) -- (外傷・熱傷による組織損傷・欠損の治療)

Pepars (114), 41-52, 2016-06
NAID 40020892234

Z形成による治療成績 (特集デュピュイトラン拘縮治療の最前線) -- (腱膜部分切除における工夫)

形成外科 59(6), 581-590, 2016-06
NAID 40020868353

症例上眼瞼脂腺癌に対し腫瘍切除術および眼瞼再建術を施行した1例 (東邦医学会雑誌)

東邦医学会雑誌 1(4), 261-264, 2015-12
NAID 120005691949

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