Five Flap Z Plasty: Innovative Approaches for Scar Contracture Release

This book chapter presents a case report and discussion on the use of the five-flap Z-Plasty technique for the release of scar contractures in a patient with a type IA post-burn contracture in the right axilla. The case presentation describes the preoperative condition of restricted shoulder movements due to the contracture and the surgical intervention involved in contracture release and reconstruction using the five-flap Z-Plasty technique.

The operative procedure included bio geometric marking of the Z-Plasty pattern, incision, and mobilization of triangular flaps to release the contracture. Adequate shoulder abduction was achieved by transposing the lateral Z-Plasty triangular flaps and performing a central Y-V Plasty through the advancement of the central triangular flap. The postoperative period remained uneventful, except for tip necrosis of the lateralmost triangular flap, which was managed conservatively. Satisfactory results were observed during follow-up examinations.

The discussion section introduces the five-flap Z-Plasty technique as a surgical approach for scar contractures and tissue defects. The surgical technique is described, including patient evaluation and planning, marking the Z-Plasty pattern, incision, flap elevation, transposition, and closure. The advantages of the technique, such as tension redistribution, scar camouflage, increased tissue length, and versatility, are highlighted. The limitations, including scar remodelling, surgical expertise, and potential complications, are also discussed.

The abstract emphasizes the significance of the five-flap Z-Plasty technique in releasing scar contractures and improving functional and aesthetic outcomes for patients. It emphasizes the importance of proper patient evaluation, precise surgical technique, and postoperative wound care to achieve optimal results. By understanding the principles and considerations of the five-flap Z-Plasty technique, surgeons can effectively address scar contractures and improve the quality of life for their patients.