Gahhos F N, Cuono C B
Section of Surgery, Venice Hospital, Fla.
Plast Reconstr Surg. 1990 Jun;85(6):869-73; discussion 874-7. doi: 10.1097/00006534-199006000-00006.
The double-Z rhombic technique of repair of excisional defects is characterized by borrowing the required tissue from two nonadjacent opposite sides of the defect. Most other flaps borrow the required tissue from a single adjacent region or all adjacent directions. The "sharing" of tissue from two opposite regions minimizes tension in that direction, while not borrowing from the remaining regions prevents the distortion of anatomic landmarks located along that direction. The orientation of the final scar and direction of tissue tension can be controlled by rotating the rhombic defect about its central axis. This study was undertaken to assess the utility of the double-Z rhombic technique in terms of cosmesis and avoidance of displacement of mobile anatomic landmarks such as eyelids, eyebrows, nasal alae, and lips. Excisional defects resulting from removal of skin neoplasms in 30 patients in whom primary closure or reconstruction with direct tissue advancement was not feasible and displacement of facial landmarks was undesirable were reconstructed using the double-Z rhombic technique. No considerable asymmetry or facial anatomic landmark deformity was observed in any of the 30 patients. Our results are presented along with representative illustrations.
双Z菱形修复切除性缺损技术的特点是从缺损的两个不相邻的相对侧借用所需组织。大多数其他皮瓣是从单个相邻区域或所有相邻方向借用所需组织。从两个相对区域“共享”组织可使该方向的张力最小化，而不从其余区域借用组织可防止沿该方向的解剖标志变形。最终瘢痕的方向和组织张力的方向可通过围绕菱形缺损的中心轴旋转来控制。本研究旨在评估双Z菱形技术在美容方面的效用，以及避免眼睑、眉毛、鼻翼和嘴唇等可移动解剖标志移位的情况。对30例因切除皮肤肿瘤导致切除性缺损且无法进行一期缝合或直接组织推进重建且面部标志移位不可取的患者，采用双Z菱形技术进行重建。30例患者中均未观察到明显的不对称或面部解剖标志畸形。我们的结果与代表性插图一并呈现。
