逆向瘢痕改型术在片状瘢痕挛缩松解中的应用

Reverse-Z -plasty and its variations to release plane scar contracture

目的 将瘢痕改型术应用于片状瘢痕挛缩的松解,以获得持久可靠的松解效果。方法 25例28处片状瘢痕挛缩患者,按垂直轴线瘢痕挛缩改型松解术的逆过程,在片状瘢痕内设计局部皮瓣,转移后缝合。结果 28处瘢痕改型显示效果良好,均未发生瘢痕瓣坏死,瘢痕松解后,相关的面部五官恢复正常解剖位置,颌颈、四肢部位功能活动恢复正常。结论 逆向瘢痕改型术可有效应用于已成熟软化,呈轻、中度挛缩的片状瘢痕的松解,避免了取、植皮术的各种缺陷。

Objective Z plasty and its variations are traditionally applicable to release sear contracture by increas-ing the length along the axis of the scar. We applied these procedures to release contractures of plane scars without apparent contractive axes. Methods Local flaps were designed in plane scars as a reverse course of Z plasty or its variations to release axial scar contracture in the transverse direction. Results Reverse-Z-plasties or their variations were applied to release contracture in 28 plane scars. With no necrosis, they were all released to let the in-volved organs return to normal position or finish functional action. Conclusion Reverse-Z-plasty and its variations are effective to release mild or moderate contracture of plane scars. This technique has become mature.