Technique of Z plasty
- Skin Grafts: for hand defects;
- indicate for soft tissue contracture including Dupuytren's;
- all three parts of the Z plasty should always be of equal length;
- angle: most often a 60 deg Z plasty is used;
- one must plan whether one large Z plasty versus several small Z plasties will be required;
- incise central limb which is inline w/ soft tissue contracture;
- incise one limb of the Z plasty and raise a flap;
- w/ a single pronged skin hook pull the edge of the flap across the central limb;
- it is important that this limb can be pulled easily across the midline;
- if there is tension, a smaller Z plasty needs to be performed, which means that part of the limb needs to be resutured;
- at this point, incise the second limb of the Z plasty;
- suture down the transposed flap;
- w/ severe soft tissue contracture, the flaps will often auto-transpose
Z-plasties and related procedures for the hand and upper limb.
The Z-plasty in hand surgery.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Tuesday, May 22, 2012 3:22 pm