Comparison of Gain In Length After Post Burn Contracture Release By Z-Plasty And Square Flap

Authors

  • Aiman Naseem Department of Plastic Surgery/Dow University of Health Sciences, Civil Hospital Karachi Pakistan
  • Faisal Akhlaq Department of Plastic Surgery/Dow University of Health Sciences, Civil Hospital Karachi Pakistan
  • Hyder Ali Department of Plastic Surgery/Dow University of Health Sciences, Civil Hospital Karachi Pakistan
  • Usamah bin Waheed Department of Plastic Surgery/Dow University of Health Sciences, Civil Hospital Karachi Pakistan
  • Erum Naz Department of Plastic Surgery/Dow University of Health Sciences, Civil Hospital Karachi Pakistan.
  • Maryam Noor Department of Plastic Surgery/Dow University of Health Sciences, Civil Hospital Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.8447

Keywords:

Gain in length, Post burn contracture Release, Square Flap, Z-plasty

Abstract

Objective: To compare the mean differences in gain in length after post-burn contracture release by z-plasty and square flap.

Study Design: Case Series

Place and Duration of Study: Plastic and Reconstructive Surgery Department, Dr Ruth KMPfau Civil Hospital, Karachi Pakistan, from Apr to Sep 2021.

Methodology: Sixty patients were divided as Z-plasty and square flap groups. The length of the contracture zone was measured. Z-plasty was performed to improve the functional and cosmetic appearance of the scar. A square flap was made to release the contracture. Splintage was maintained for two weeks after its release.

Results: The mean contracture length three weeks after Z-plasty release was 7.12±4.14cm and 15.39±4.66cm in square flap. Significant mean differences among techniques were observed among contracture length (p=0.001) and gain in length (p=0.001). The cubital fossa was the most common region treated with Z-plasty, while the finger was the most common region treated with square flap. The results showed a highly significant association of regions with respect to surgical techniques (p=0.001). An insignificant association was observed between gender (p=0.436) and cause of burn (p=0.136).

Conclusion: The square flap technique provides greater length gains than a Z-plasty technique.

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References

Mathers CD, Bernard C, Iburg KM, Inoue M, Ma Fat D, Shibuya

K, et al. Global burden of disease in 2002: data sources, methods

and results. WHO Geneva; 2003.

Iqbal T, Saaiq M. The burnt child: an epidemiological profile and

outcome. J Coll Physicians Surg Pak 2011 ; 21(11): 691-694.

Ahuja RB, Dash JK, Shrivastava P. A comparative analysis of

liquefied petroleum gas (LPG) and kerosene related burns.

Burns 2011; 37(8): 1403-1410.

https://doi.org/10.1016/j.burns.2011.03.014

Sarma BP. Epidemiology and man-days loss in burn injuries

amongst workers in an oil industry. Burns 2001; 27(5): 475-480.

https://doi.org/10.1016/s0305-4179(00)00157-1

Bhattacharya V, Purwar S, Joshi D, Kumar M, Mandal S,

Chaudhuri GR, et al. Electrophysiological and histological

changes in extrinsic muscles proximal to post burn contractures

of hand. Burns 2011; 37(4): 692-697.

https://doi.org/10.1016/j.burns.2011.01.020

Hayashida K, Akita S. Surgical treatment algorithms for postburn contractures. Burns Trauma 2017; 5(1): 9-16.

https://doi.org/10.1186%2Fs41038-017-0074-z

Hove CR, Williams III EF, Rodgers BJ. Z-plasty: a concise

review. Facial Plast Surg 2001; 17(04): 289-294.

https://doi.org/10.1055/s-2001-18828

Altun S, Çakır F, Öztan M, Okur Mİ, Bal A. Do rhomboid flaps

provide more elongation than Z-plasty flaps? An experimental

study. J Plastic Surg Hand Surg 2018; 52(3): 148-152.

https://doi.org/10.1080/2000656x.2017.1372287

Hyakusoku H, Fumiiri M. The square flap method. British J

Plastic Surg 1987; 40(1):40-46. https://doi.org/10.1016/0007-

(87)90009-9

Hifny MA. The square flap technique for burn contractures:

clinical experience and analysis of length gain. Ann Burns Fire

Disasters 2018 ; 31(4): 306-312.

Karki D, Narayan RP. Role of square flap in post burn axillary

contractures. World J Plast Surg 2017; 6(3): 285–291.

Fernandez-Palacios J, Bayón PB, Sánchez OC, Duque OG.

Multilevel release of an extended postburn contracture. Burns

; 28(5): 490-493. https://doi.org/10.1016/s0305-

(01)00120-6

Aslan G, Tuncali D, Cigsar B, Barutcu AY, Terzioglu A. The

propeller flap for postburn elbow contractures. Burns 2006;

(1): 112-115. https://doi.org/10.1016/j.burns.2005.07.007

Baux S, Mimoun M, Kirsch JM, Zumer L, Berard V. Treatment of

elbow contractures in burns. Burns 1987; 13(3): 241-244.

https://doi.org/10.1016/0305-4179(87)90175-6

Lai CS, Lin SD, Tsai CC, Tsai CW. Running Y-V-plasty for burn

scar contracture. Burns 1995; 21(6): 458-462.

https://doi.org/10.1016/0305-4179(95)00019-8

Vartak A, Keswani MH. X-plasty for repair of burn contractures.

Burns 1992; 18(4): 326-328. https://doi.org/10.1016/0305-

(92)90156-o

Hyakusoku H, Fumiiri M. The square flap method. British J

Plastic Surg 1987; 40(1): 40-46. https://doi.org/10.1016/0007-

(87)90009-9

Ulkur E, Acıkel C, Evinc R, Celikoz B. Use of rhomboid flap and

double Z-plasty technique in the treatment of chronic postburn

contractures. Burns 2006; 32(6): 765-769.

https://doi.org/10.1016/j.burns.2006.01.015

Ertas NM, Küçükçelebi A, Erbas O, Bozdogan N. Comparison of

elongations provided by subcutaneous pedicle rhomboid flap

and Z-plasty in rat inguinal skin. Plast Reconstruct. Surg 2006;

(2): 486-90.

https://doi.org/10.1097/01.prs.0000197212.84348.db

Ostrowski DM, Feagin CA, Gould JS. A three-flap web-plasty

for release of short congenital syndactyly and dorsal adduction

contracture. J Hand Surg 1991; 16(4): 634-641.

https://doi.org/10.1016/0363-5023(91)90186--f

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Published

28-06-2024

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Original Articles

How to Cite

1.
Naseem A, Faisal Akhlaq, Hyder Ali, Usamah bin Waheed, Erum Naz, Maryam Noor. Comparison of Gain In Length After Post Burn Contracture Release By Z-Plasty And Square Flap. Pak Armed Forces Med J [Internet]. 2024 Jun. 28 [cited 2024 Jul. 17];74(3):758-62. Available from: https://pafmj.org/PAFMJ/article/view/8447