A mathematical model to predict the requirement for multiple Z plasties

Ellur, Sunderraj

doi:10.4103/0970-0358.41129

Cited by 4 publications

(4 citation statements)

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“…20 One of the primary goals of z-plasty is to interrupt the tension lines on a scar. 21–23 Notably, the present study showed that the size of the keloid did not influence the recurrence rate. Thus, our protocol is suitable for small to moderately sized keloids.…”

Section: Discussionsupporting

confidence: 42%

Z-plasty and Postoperative Radiotherapy for Anterior Chest Wall Keloids: An Analysis of 141 Patients

Arima

Dohi

Kuribayashi

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: The therapies for anterior chest wall keloids include surgical excision, postoperative radiotherapy, silicone taping stabilization, and steroid plaster. However, to date, there is no universally accepted combination treatment strategy for anterior chest wall keloids. Methods: All consecutive patients with single or multiple anterior chest wall keloids who underwent keloid excision, tension-reducing suturing, z-plasty, and postoperative radiotherapy in 2013–2016 in Nippon Medical School were included in this case series study. Only keloids that arose from small injuries such as folliculitis or acne were selected. The surgery was followed by tension-reducing self-management of the wounds with silicone tape and steroid plaster. The postsurgical radiotherapy modality was 18 Gy administered in 3 fractions over 3 days. The primary study outcome was keloid recurrence during the 24-month follow-up period. Recurrence was defined as the development of stiff and red lesions in even a small part of the scar that did not respond to 6 months of steroid plaster therapy. Results: In total, 141 patients with 141 lesions were enrolled. Of the 141 lesions, 15 (10.6%) recurred. All recurrences were successfully treated by steroid plaster and steroid injection. The recurrence patients did not differ from the nonrecurrence patients in terms of the size of the original keloid or gender distribution. Conclusions: Anterior chest wall keloids can be successfully treated by customized plans that involve appropriate surgical modalities (including z-plasty) followed by postoperative radiotherapy (18 Gy in 3 fractions over 3 days) and scar self-management with silicone tape and steroid plaster.

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Section: Discussionsupporting

confidence: 42%

Z-plasty and Postoperative Radiotherapy for Anterior Chest Wall Keloids: An Analysis of 141 Patients

Arima

Dohi

Kuribayashi

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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“…Compare to the previous studies 1,11 , our new version of mathematical models are easier to use, to remember and can estimate the final outcomes of multiple Z plasty not only the percentage of scar lengthening but also the flap tension and area of distortion.…”

Section: Discussionmentioning

confidence: 98%

Formulaic Prediction of Z-Plasty Outcomes Relative to Z Scar Lengthening, Z Flap Tension, and Area of Distortion, and Determination of the Multiple Z-Plasty Configurations that Optimally Increase Z Scar Length, Decrease Z Flap Tension, and Decrease Area of Distortion

Akaranuchat

2019

Smj

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Objective: To generate mathematical formulas to predict Z-plasty outcomes relative to Z scar lengthening, Z flap tension, and area of distortion, and to determine the multiple Z-plasty configurations that optimally increase Z scar length, decrease Z flap tension, and decrease area of distortion. Methods: Each Z-plasty configuration was evaluated for highest percent Z scar lengthening, lowest tension to close Z flap, and lowest area of distortion. For part 1 of the study, conventional one-flap, two-flap, four-flap, and eight-flap Z-plasties were created, after which relocation of the Z flaps was performed. The outcomes were analyzed and formulas were generated to predict Z-plasty outcomes. In part 2, the following modifications to the four-flap Z-plasty were made: modification of Z flap angle, modification of Z flap limb size, and addition of a gap between each Z flap. Outcomes were evaluated to identify the configuration that produced the optimal outcome for each outcome measure. Results: Thirty-six pig skins were incised and sutured under controlled condition. For part 1, one-flap Z-plasty was best for Z scar lengthening, and 8-flap Z-plasty was best for reducing both tension to close and area of distortion. Three formulas were generated to predict the studied outcomes of Z-plasty. For part 2, the configuration that added a gap of 75% of the central limb length yielded the best outcome for scar length and also work very well for reducing the tension to close. The conventional design was the best for minimizing area of distortion. Conclusion: Mathematical formulas were generated to predict Z scar percent lengthening, Z flap tension to close, and area of distortion. Addition of a gap 75% of the central limb length was the most efficacious Z-plasty configuration for increasing Z scar length.

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“…Over the ages, various modifications of this technique have appeared in literature which concern the extent of elongation of the linear scar,[ 1 ] the planimetric properties,[ 2 ] and size of the Z in relation to the available laxity. [ 3 ] This article attempts to more profoundly evaluate the properties of Z plasty in respect to the change in direction of the common limb in a Z plasty. It is well known that in a classic or 60° Z plasty the common limb rotates by 90°.…”

Section: Introductionmentioning

confidence: 99%

A mathematical model to predict the change in direction of the common limb in Z plasty

Ellur¹,

Guido²

2009

Indian J Plast Surg

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A mathematical model to predict the requirement for multiple Z plasties

Cited by 4 publications

References 1 publication

Z-plasty and Postoperative Radiotherapy for Anterior Chest Wall Keloids: An Analysis of 141 Patients

Z-plasty and Postoperative Radiotherapy for Anterior Chest Wall Keloids: An Analysis of 141 Patients

Formulaic Prediction of Z-Plasty Outcomes Relative to Z Scar Lengthening, Z Flap Tension, and Area of Distortion, and Determination of the Multiple Z-Plasty Configurations that Optimally Increase Z Scar Length, Decrease Z Flap Tension, and Decrease Area of Distortion

A mathematical model to predict the change in direction of the common limb in Z plasty

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