Altun Serdar, Çakır Fatih, Öztan Mehmet, Okur Mehmet İhsan, Bal Ali
a Division of Plastic Surgery, Department of Surgery , Fırat University School of Medicine , Elazığ , Turkey.
b Division of Plastic Surgery, Department of Surgery , Necip Fazıl State Hospital , Kahramanmaraş , Turkey.
J Plast Surg Hand Surg. 2018 Jun;52(3):148-152. doi: 10.1080/2000656X.2017.1372287. Epub 2017 Sep 4.
A Z-plasty flap is one of the most widely used geometric relaxation methods to release contracture bands. A rhomboid flap is a lesser used geometric relaxation method than a Z-plasty flap. This study aimed to determine the length and rate of elongation provided by rhomboid and Z-plasty flaps.
Bilateral contracture bands were created in the inguinal skins of rats. A rhomboid flap was planned for the right side of the inguinal region, and a single Z-plasty flap was planned for the left side. The length and rate of elongation provided by the two flaps were calculated after completing the procedures and were compared using Student's t-test.
Experimental contracture bands disappeared in both the inguinal regions after creating rhomboid and Z-plasty flaps. The mean postoperative elongation of the contracture band was 1.4 ± 0.119 and 2.47 ± 0.281 cm using the rhomboid and Z-plasty flaps, respectively. The difference was statistically significant (p < .001).
Z-plasty flaps provide more elongation than rhomboid flaps and also appear to be better options for releasing linear contracture bands. However, rhomboid flaps may be used as alternatives when Z-plasty flaps cannot be used and in regions such as the axilla, genital region, nipple-areola, where their distortion effects should be avoided.
Z形皮瓣是用于松解挛缩带最常用的几何松弛方法之一。菱形皮瓣是一种比Z形皮瓣使用较少的几何松弛方法。本研究旨在确定菱形皮瓣和Z形皮瓣提供的延长长度和延长率。
在大鼠腹股沟皮肤制作双侧挛缩带。在腹股沟区右侧设计一个菱形皮瓣，左侧设计一个单一的Z形皮瓣。完成手术后计算两个皮瓣提供的延长长度和延长率，并采用Student's t检验进行比较。
制作菱形皮瓣和Z形皮瓣后，两侧腹股沟区的实验性挛缩带均消失。使用菱形皮瓣和Z形皮瓣时，挛缩带术后平均延长长度分别为1.4±0.119 cm和2.47±0.281 cm。差异具有统计学意义（p<0.001）。
Z形皮瓣比菱形皮瓣提供更多的延长，似乎也是松解线性挛缩带的更好选择。然而，当不能使用Z形皮瓣时，以及在腋窝、生殖器区域、乳头乳晕等应避免其变形影响的区域，菱形皮瓣可作为替代方案。
