Z-plasty – Basic Surgical Technique for Post-burn Patients
DOI:
https://doi.org/10.2478/AMB-2025-0004Keywords:
Z-plasty, Burns, Post-burn contracture, Surgical treatmentAbstract
Background: In the majority of patients, the consequences of burns often require surgery due to complications like contracture. Various surgical techniques are employed for correction, including free skin grafting, local tissue plasty, and free flaps. This study focuses on Z-plasty as a surgical technique for correcting scar deformities after burns. Materials and Methods: We treated 84 patients with burn consequences. Z-plasty was the main method for 67 patients, while 17 patients received Z-plasty combined with other techniques: 11 with split-thickness skin grafts, 4 with non-free skin plasty, 1 with a combination of Z-plasty, tissue expander, and local tissue plasty, and 1 with two diff erent Z-plasty sites. Results: Early complications occurred in 8 patients. One case resulted in infl ammation and dehiscence of the plasty. In 6 cases, partial lysis of the vertices of the triangles was observed, which healed
spontaneously. Conclusions: Despite some early complications, Z-plasty proves to be a successful treatment method for scar deformities post-burn. The results are generally satisfactory, demonstrating the efficacy of this technique in most cases.
References
Barhudarova NR. Povyshenie jeff ektivnosti hirurgicheskoj reabilitacii detej s posleozhogovymi rubcovymi deformacijami i kontrakturami sustavov konechnostej s ispol’zovaniem rekonstruktivnoplasticheskih operacij [dissertation]. Moscow; 2009. [in Russian].
Povstyanoy NE. Vosstanovitel’naya khirurgiya ozhogov [Reconstructive surgery for burns]. Moscow; 1973. [in Russian].
Mcgregor IA. The theoretical basis of the Z-plasty. Br J Plast Surg 1957;9(4):256–9
Limberg AA. Mathematical principles of local plastic procedures on the of the human body. Leningrad: Medgis, 1946.
Suzuki S, Um SC, Kim BM et al. Versatility of modifi ed planimetric Z-plasties in the treatment of scar with contracture. Br J Plast Surg 1998, 51:363–369
Hudson DA. Some thoughts on choosing a Z-plasty: the Z made simple. Plast Reconstr Surg. 2000; 106:665-71.
Aasi SZ. Z-plasty made simple. Dermatol Res Pract. 2010; 982623. doi: 10.1155/2010/982623.
Pеrez-Bustillo A, Gonzаlez-Sixto B, Rodriguez-Prieto MA. Surgical Principles for Achieving a Functional and Cosmetically Acceptable Scar December 2012
Ulkur E, Acikel C, Evinc R, Celikoz B. Use of rhomboid flap and double Z-plasty technique in the treatment of chronic postburn contractures. Burns. 2006 Sep;32(6):765-9. doi: 10.1016/j.burns.2006.01.015.
Roggendorf E. Planimetric elongation of skin by Z-plasty. Plast Reconstr Surg, 1982, 69:306–316
Roggendorf E. The planimetric Z-plasty. Plast Reconstr Surg, 1983, 71:834–842
Rohrich RJ, Zbar RI. A simplifi ed algorithm for the use of Zplasty 1999;103:1513–8
Dufourmentel, C. An L-shaped fl ap for lozenge-shaped defects. Transactions the Third International Congress of Plastic Surgery, 1963, 772. Amsterdam: Medical Foundation
Kamolz LP, Lumenta DB. Dermal Replacements in General, Burn and Plastic Surgery,Tissue Engineering in Clinical Practice, Springer-Verlag Wien 2013
Frodel Jr JL, Wang TD. Z-plastia. In: Baker SR, editor. Colgajos locales en la reconstrucciуn facial. 2nd ed. Philadelphia: Amolca; 2010. p. 313-36.
Furnas DW, Fischer GW. The Z-plasty: biomechanics and mathematics. Br J Plast Surg 1971; 24:144-60.
Fader DJ, Wang TS, Johnson TM. The Z-plasty transposition fl ap for reconstruction of the middle cheek. J Am Acad Dermatol. 2002;46:738-42.
Koyama H, Fujimori R. V-W plasty. Ann Plast Surg 1982; 9:216-219.
Suzuki S, Matsuda K, Nishimura Y. Proposal for a new comprehensive classification of V-Y plasty and its analogues: The pros and cons of inverted versus ordinary Burow’s triangle excision. Plast Reconstr Surg 1996; 98: 1016-1022
Park TH, Park JH, Chank CH. Clinical features of food keloids treated using surgical excision and fi ll thickness skin grafting followed by corticosteroid injections. J Foot Ankle Res 2013; 6:26.
Haddad D, Gemperli R. Surgical correction of aesthetically deformed eyebrows using local transposition fl aps. Aesthetic Plast Surg. 2010; 34:734-7.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 V. Anastasova, P. Kiskinov, A. Georgiev, K. Ivanova, E. Krasteva, K. Atliev, E. Zanzov (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
You are free to share, copy and redistribute the material in any medium or format under these terms.
Journal Acta Medica Bulgarica 
