Ertaş Nilgün Markal, Borman Hüseyin, Deniz Murat, Haberal Mehmet
Başkent University Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Ankara, Turkey.
Burns. 2008 Feb;34(1):114-8. doi: 10.1016/j.burns.2007.01.015. Epub 2007 Jul 9.
Z-plasty is a well-known and commonly used local flap technique in the treatment of contracture bands. Double opposing rectangular advancement is a new and alternate local flap design which can be used in the treatment of wide and linear postburn scar contractures. The technique consists of opposition of two adjacent rectangular flaps by advancement. This experimental study compares lengthening provided by Z-plasty and double opposing rectangular advancement.
Lower extremities of 10 male Sprague-Dawley rats were strained by hanging 400 g of weight to provide tension lines over both inguinal areas. We planned Z-plasty with 2 cm central limb and with 60 degrees angles to the inguinal tension line on one side. On the other side, we sketched double adjacent rectangular flaps with 2 cm long axis and 1cm short axis over the tension line. Triangular flaps were elevated over the muscle, transposed and sutured in Z-plasty. Rectangular flaps were incised down to the muscle, advanced and opposed to each other before suturing. The final lengthening provided by both techniques were measured and the results were statistically analysed.
Both Z-plasty and double opposing rectangular advancement techniques were effective in relief of tension over both inguinal areas and in lengthening the tension lines. Z-plasties provided lengthening ranging between 4 and 4.6 cm. The difference between pre- and post-operative (Delta) measurements in Z-plasty ranged between 2-2.6 cm (mean+/-standard deviation=2.26+/-0.24 cm). The lengthening provided by double opposing rectangular advancement were between 3.9 and 4.5 cm and the Delta measurements ranged between 1.9 and 2.5 cm (mean+/-S.D.=2.22+/-0.22 cm). Statistical analysis revealed that the elongation provided by both techniques are not significantly different from each other (p>0.05).
Double opposing rectangular advancement technique elongates a tension line as much as Z-plasty in the rat inguinal skin.
Z 成形术是治疗挛缩带时一种广为人知且常用的局部皮瓣技术。双相对矩形推进术是一种新型的替代性局部皮瓣设计，可用于治疗广泛的线性烧伤后瘢痕挛缩。该技术通过推进使两个相邻的矩形皮瓣相对。本实验研究比较了 Z 成形术和双相对矩形推进术所提供的延长效果。
对 10 只雄性斯普拉格 - 道利大鼠的下肢施加 400 克重量进行牵拉，以在双侧腹股沟区域形成张力线。我们计划在一侧采用中央臂长 2 厘米且与腹股沟张力线呈 60 度角的 Z 成形术。在另一侧，我们在张力线上勾勒出长轴为 2 厘米、短轴为 1 厘米的双相邻矩形皮瓣。在 Z 成形术中，在肌肉上方掀起三角形皮瓣，转移并缝合。矩形皮瓣向下切开至肌肉，推进并在缝合前相互对合。测量两种技术所提供的最终延长长度，并对结果进行统计学分析。
Z 成形术和双相对矩形推进术在缓解双侧腹股沟区域的张力以及延长张力线方面均有效。Z 成形术提供的延长长度在 4 至 4.6 厘米之间。Z 成形术术前和术后（Δ）测量值之间的差异在 2 - 2.6 厘米之间（均值±标准差 = 2.26±0.24 厘米）。双相对矩形推进术提供的延长长度在 3.9 至 4.5 厘米之间，Δ测量值在 1.9 至 2.5 厘米之间（均值±标准差 = 2.22±0.22 厘米）。统计学分析表明，两种技术所提供的延长效果彼此无显著差异（p > ０.05）。
在大鼠腹股沟皮肤中，双相对矩形推进术使张力线延长的程度与 Z 成形术相同。
