- Jesse Selber, MD, MPH
Jesse Selber, MD, MPH
- Assistant Professor
- MD Anderson Cancer Center, University of Texas
The basic Z-plasty is composed of a central limb incision and two lateral limb incisions that form a "Z." The lengths of the three limbs and the angles formed between the central and lateral limbs are equal. The incisional pattern creates two triangular tissue flaps that are transposed, changing both the length and orientation of a wound or scar.
This topic will review the indications and technique for Z-plasty. Simple wound closure with sutures and staples is discussed elsewhere. (See "Closure of minor skin wounds with sutures" and "Closure of minor skin wounds with staples".)
The primary reasons to perform a Z-plasty are to improve contour, release scar contracture, relieve skin tension, and mobilize tissue for reconstructive surgery. This technique is rarely needed for the acute management of open wounds.
Z-plasty has four main tissue effects:
●Redirection of scar – The new scar reorients from the axis of the central limb to a line connecting the tips of the lateral limbs. Z-plasty is used to redirect scar into "relaxed skin tension lines" (ie, Langer's lines) (figure 1), natural skin folds, or along the border of an aesthetic unit (ie, nasolabial fold) to improve cosmetic or functional outcome.
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- TYPES OF Z-PLASTY
- Z-plasty variations
- PREOPERATIVE ISSUES
- Wound/scar evaluation
- Antibiotic prophylaxis
- Patient counseling
- Preoperative marking
- General technique
- POSTOPERATIVE CARE
- Special wound considerations
- SUMMARY AND RECOMMENDATIONS