Başkent Üniversitesi Yayınları

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Has files: YesSubject: search.filters.subject.Contracture release

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    New Advantages of Double Combined Z-Plasty for Wide Burn Scar Contracture
    (Başkent Üniversitesi, 2023-09) Ken Yamashita; Takatoshi Yotsuyanagi; Shinji Kato; Ayaka Kitada; Masahiro Onuma; Nobuyuki Mitsuhashi; Asako Miyabayashi; Naohiro Ueda; Jiro Harada
    ABSTRACT ABSTRACT OBJECTIVES: The double combined Z-plasty technique was developed for treating wide scar contractures. The major advantages are that the scar can be completely divided by the skin inserted from both sides, a greater elongation effect can be obtained in the full width of the scar than with conventional Z-plasty, the zigzag suture line prevents recurrence of contractures, the design is simple, and the procedure is easy. We successfully treated a variety of burn scar contractures using this technique and had additional advantages that were not documented in the original report. MATERIALS AND METHODS: We treated 3 cases of burn scar contractures using the double combined Z-plasty technique. RESULTS: The burn scar contractures were successfully released by this technique. The technique allows for expansion and growth in small children with adequately sized triangular flaps of intact skin. In addition, the flap size can be adjusted according to needs during the procedure. Even when the surrounding skin is a scar tissue, the technique can provide a marked improvement. In addition, this technique is well-suited to multidirectional joints such as the neck and axillar area. CONCLUSIONS: Burn scar contractures require varying techniques according to the degree, width, and area affected. The double combined Z-plasty should be considered as an effective technique for wide burn scar contractures.
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    Availability of Reduction Mammoplasty for Neck Burn Scar Contracture in Women
    (Başkent Üniversitesi, 2022-09) Takatoshi Yotsuyanagi; Ken Yamashita; Ayako Gonda; Chihiro Teramura; Masahiro Onuma; Asako Miyabayashi; Toshimasa Tennoji; Marimi Funahashi; Kaiji Nishibata
    ABSTRACT Severe scar contracture can easily occur after a burn injury in the neck region, resulting in a functional decline that affects daily living. Because a hard scar tissue in the neck widely extends into the anterior chest wall in patients with severe burns, excessive forces should be exerted to extend the neck. We found that the impact force by the weight of the breast sometimes intensifies contracture tendency and leads to the recurrence of the contracture in women. To date, medical reports have paid little attention to this. We performed reduction mammoplasty on 3 female patients with neck burn scar contractures before the release of neck scar. About 200 g of tissue were removed from each breast according to the McKissock technique. In 1 case, the skin was moved to the axilla as a skin flap to release the contracture. The remaining neck scar contracture was then reconstructed with a local flap or free flap. In all 3 patients, mammoplasty and neck reconstruction were performed without complications and with good results. No recurrence of contracture occurred. Reduction mammoplasty in advance reduced the level of neck scar contracture and allowed for a variety of reconstruction options, including local skin flaps, and was also effective in preventing postoperative recurrence.
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    Z-Plasty for Release of Postburn Finger Contractures in Pediatric Patients
    (Başkent Üniversitesi, 2022-03) Can İlker Demir; Emrah Kağan Yaşar; Batuhan Polat; Alperen Aras; Murat Şahin Alagöz
    ABSTRACT OBJECTIVES: Finger contractures after burn injuries remain significant problems in pediatric patients. The severity of the contracture increases with age. In this study, we describe the technical details and importance of contracture treatment with Z-plasty in patients with finger contractures. MATERIALS AND METHODS: For this study, we included 48 patients younger than 18 years of age who developed finger contractures after burn injuries. All patients had restricted finger movements because of contracture, and all patients received single or multiple surgeries with the Z-plasty technique. We did not include patients who could not be followed up for more than 1 year. RESULTS: Complete recovery was observed in all 48 patients with daily dressing. We did not observe any infections, hematomas, suture separations, or total necrosis in any of the patients. We provided full-thickness skin grafts to 8 patients (16.7%). Seven patients (14.6%) developed superficial necrosis in the distal end of the flaps. None of the patients required additional surgical interventions. CONCLUSIONS: The Z-plasty technique has an important place in the treatment of burn contractures. Simple and rapid recovery can be achieved with a single or with multiple z-plasty surgeries both in complicated cases, which have functional limitations, and in simple cases.