Rationale: Webbed scar contractures deformity caused by burns and other factors will lead to joint disorders and affect the mental health of patients, resulting in a severe decline in quality of life. Rapid, effective...Rationale: Webbed scar contractures deformity caused by burns and other factors will lead to joint disorders and affect the mental health of patients, resulting in a severe decline in quality of life. Rapid, effective and less complicated surgical methods can help patients with post-burn rehabilitation. Objective: This article argues that a modified Z-plasty can quickly improve the range of motion caused by webbed scar contractures in joint areas, including surgical methods, postoperative care and prognosis. Methods and Results: The study took place from 2018 to 2022. Thirty-two patients with joint scar contracture deformity, with a mean age of 32.5 years, were included in the study. All patients underwent contracture scar revision and modified Z-plasty repair under anesthesia. All the flaps survived and the joint function was improved. Compared with the traditional Z-plasty, the duration of the operative procedure of the modified Z-plasty was significantly shorter, more surrounding scar tissue was mobilized, and the effectiveness of postoperative scar contracture release was better. Discussions: The modified Z-plasty for scar contracture deformity in joint area is simple, rapid, effective and easy to manage.展开更多
A median cleft lip is a rare central midline deficiency of the upper lip. Multiple surgical techniques are described in the literature to address this defect, though there is little consensus on the preferred surgical...A median cleft lip is a rare central midline deficiency of the upper lip. Multiple surgical techniques are described in the literature to address this defect, though there is little consensus on the preferred surgical technique. We describe an intra-oral approach for repair of the median upper lip cleft using mucosal Z-plasty. This technique provides excellent access to the attenuated orbicularis oris muscle and the frenulum fibrosed to the labial margin. The tethered lip can be mobilized and the notch converted with appropriate mucosal length, lip height, and vermillion fullness. The contour of the free labial border immediately improves, all while avoiding a cutaneous scar. The midline cleft lip notch can be effectively treated by adhering to 3 major principles: 1) excision of the tight, constrictive labial band;2) achieving midline orbicularis oris muscle approximation;and 3) establishing mucosal lengthening using a Z-plasty.展开更多
Scars are the final result of the four processes that constitute cutaneous wound healing,namely,coagulation,inflammation,proliferation,and remodeling.Permanent scars are produced if the wounds reach the reticular derm...Scars are the final result of the four processes that constitute cutaneous wound healing,namely,coagulation,inflammation,proliferation,and remodeling.Permanent scars are produced if the wounds reach the reticular dermis.The nature of these scars depends on the four wound healing processes.If the remodeling process is excessive,collagen degradation exceeds collagen synthesis and atrophic scars are produced.If the inflammation phase is prolonged and/or more potent for some reason,inflammatory/pathological scars such as keloids or hypertrophic scars can arise.If these pathological scars are located on joints or mobile regions,scar contractures can develop.When used with the appropriate timing and when selected on the basis of individual factors,surgical techniques can improve mature scars.This review paper focuses on the surgical techniques that are used to improve mature scars,burn scars,and scar contractures.Those methods include z-plasties,w-plasties,split-thickness skin grafting,full-thickness skin grafting,local flaps(including the square flap method and the propeller flap),and expanded flaps,distant flaps,regional flaps,and free flaps.展开更多
文摘Rationale: Webbed scar contractures deformity caused by burns and other factors will lead to joint disorders and affect the mental health of patients, resulting in a severe decline in quality of life. Rapid, effective and less complicated surgical methods can help patients with post-burn rehabilitation. Objective: This article argues that a modified Z-plasty can quickly improve the range of motion caused by webbed scar contractures in joint areas, including surgical methods, postoperative care and prognosis. Methods and Results: The study took place from 2018 to 2022. Thirty-two patients with joint scar contracture deformity, with a mean age of 32.5 years, were included in the study. All patients underwent contracture scar revision and modified Z-plasty repair under anesthesia. All the flaps survived and the joint function was improved. Compared with the traditional Z-plasty, the duration of the operative procedure of the modified Z-plasty was significantly shorter, more surrounding scar tissue was mobilized, and the effectiveness of postoperative scar contracture release was better. Discussions: The modified Z-plasty for scar contracture deformity in joint area is simple, rapid, effective and easy to manage.
文摘A median cleft lip is a rare central midline deficiency of the upper lip. Multiple surgical techniques are described in the literature to address this defect, though there is little consensus on the preferred surgical technique. We describe an intra-oral approach for repair of the median upper lip cleft using mucosal Z-plasty. This technique provides excellent access to the attenuated orbicularis oris muscle and the frenulum fibrosed to the labial margin. The tethered lip can be mobilized and the notch converted with appropriate mucosal length, lip height, and vermillion fullness. The contour of the free labial border immediately improves, all while avoiding a cutaneous scar. The midline cleft lip notch can be effectively treated by adhering to 3 major principles: 1) excision of the tight, constrictive labial band;2) achieving midline orbicularis oris muscle approximation;and 3) establishing mucosal lengthening using a Z-plasty.
文摘Scars are the final result of the four processes that constitute cutaneous wound healing,namely,coagulation,inflammation,proliferation,and remodeling.Permanent scars are produced if the wounds reach the reticular dermis.The nature of these scars depends on the four wound healing processes.If the remodeling process is excessive,collagen degradation exceeds collagen synthesis and atrophic scars are produced.If the inflammation phase is prolonged and/or more potent for some reason,inflammatory/pathological scars such as keloids or hypertrophic scars can arise.If these pathological scars are located on joints or mobile regions,scar contractures can develop.When used with the appropriate timing and when selected on the basis of individual factors,surgical techniques can improve mature scars.This review paper focuses on the surgical techniques that are used to improve mature scars,burn scars,and scar contractures.Those methods include z-plasties,w-plasties,split-thickness skin grafting,full-thickness skin grafting,local flaps(including the square flap method and the propeller flap),and expanded flaps,distant flaps,regional flaps,and free flaps.
