Z Plasty

I went on a £1500 2-day bullshit course to learn this, useless waste of money and time)…One day a genius explained it to me in 5 minutes and it left a mark on my brain and my heart, and I will love him for it always)…

Definition:

Transposition of two interdigitating equal triangles of skin flap.

Indications:

• Release contractor
• Break up a scar
• Change direction of scar
• Deepen a webspace or obliterate a depression
• Move tissue

Design:

• THE SCAR IS THE COMMON LIMB
• TO WORK OUT THE END SCAR, REMEMBER WHERE YOU’VE CUT.

The angle of the z plasty determines the potential gain in length. (25% increase for every 15°)

Angle 30%, gain in length 25%, 45°à50%, 60°à75%, 75%à100%, 90° impossible to transpose.

The smaller the angle, the more difficult for the blood supply, but the better the laxity.

Complications:

            Tip necrosis, no laxity so cant move.

Jumping Man Flap

2 Z plasties and 1 V to Y advancement flap

used for concavities e.g. Inner canthus, first webspace

(compared to bi-lobbed flap used for convexity e.g tip of nose, bulk of chin)

Multiple Z plasties

To break up a long scar                       

2 Z plasties in each other

ABCD becomes the CADBury flap