The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique · 2010
A new method in the treatment of postburn and post-traumatic scar contractures: Double-opposing Z- and V- (K-M-N) plasty.
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Emsen Ilteris Murat
Аннотация
BACKGROUND: To date, many techniques for the surgical treatment of postburn scar contractures have been described. Some of the most popular techniques are Z-plasty, V-Y-plasty and their analogues. A major limitation of these techniques is that the excess tissue requires excision of the dog ear. The current study presents a new modification of the double-opposing Z- and V-plasty, called 'K-M-N plasty'.
METHODS: Twenty postburn scar contractures were successfully treated with K-M-N plasty. The postoperative results depict the versatility of this technique in the surgical treatment of postburn scar contractures, especially in the upper and lower extremities.
RESULTS: There was no distal flap necrosis, and postoperative recovery was uneventful in all operated patients. K-M-N plasty is an effective and alternative method for the surgical treatment of postburn scar contractures. In addition, drawing and flap transpositions were not complicated.
DISCUSSION: THERE ARE MANY ADVANTAGES TO USING THIS TECHNIQUE: K-M-N plasty can be safely used when skin tension crosses the contracture line; it is superior to other local flaps because of its rich vascularity and mobility for superficial scars; it can be recommended to the inexperienced surgeon because it can be performed with ease; it is also an effective procedure for the pericontracture area due to its V limb (it can prevent recontracture); the colour and texture matches are more cosmetically acceptable, and the resultant contracture release is similar to other techniques; the dog ear formation is not seen; it can be performed under local anesthesia in most cases (not in children); and it has a shorter period of operation and hospitalization than other techniques.
METHODS: Twenty postburn scar contractures were successfully treated with K-M-N plasty. The postoperative results depict the versatility of this technique in the surgical treatment of postburn scar contractures, especially in the upper and lower extremities.
RESULTS: There was no distal flap necrosis, and postoperative recovery was uneventful in all operated patients. K-M-N plasty is an effective and alternative method for the surgical treatment of postburn scar contractures. In addition, drawing and flap transpositions were not complicated.
DISCUSSION: THERE ARE MANY ADVANTAGES TO USING THIS TECHNIQUE: K-M-N plasty can be safely used when skin tension crosses the contracture line; it is superior to other local flaps because of its rich vascularity and mobility for superficial scars; it can be recommended to the inexperienced surgeon because it can be performed with ease; it is also an effective procedure for the pericontracture area due to its V limb (it can prevent recontracture); the colour and texture matches are more cosmetically acceptable, and the resultant contracture release is similar to other techniques; the dog ear formation is not seen; it can be performed under local anesthesia in most cases (not in children); and it has a shorter period of operation and hospitalization than other techniques.