Theoretical and practical considerations in Z-plasty practice

McGregor, Ian A (1971) Theoretical and practical considerations in Z-plasty practice. Ch.M thesis, University of Glasgow.

Abstract

The Z-plasty is used in 2 main sets of circumstances: in contractures and in facial scars. In these situations it functions for practical purposes in a single plane, or, more accurately. its theoretical basis can be discussed in terms of 2 dimensions. There is, however, a group of miscellaneous uses for the z-plasty which involve a third dimension, creating a curving Z-plasty. In all of these circumstances certain modifications of method are necessary to make full use of its virtues. Many of these modifications arose Initially in the context of hand surgery, because of the strict limitations Imposed by the anatomical factors operating in the hand. The theoretical background of the Z-plasty and the practical considerations arising therefrom are discussed In relation to these 4 aspects of its use. When the Z-plasty Is used in contractures the lengthening which relieves the contracture is achieved at the expense of shortening In the axis perpendicular to the contracture. The amount of lengthening and the corresponding amount of shortening is shown to result from variation in the size of the Z-plasty angles and the length of the Z-plasty limbs. Formulae are developed to prove this fact and derive quantitative results. The formulae also permit elucidation of the factors which limit angle size and limb length of the Z-plasty as used in practice. A rationale is also provided for the use of the multiple Z-plasty, a modification of standard Z-plasty technique used when tissue available for shortening is strictly limited. Used In scars, the Z-plasty, by virtue of the fact that the central limb of the completed Z-plasty lies at an angle to its pre-operative line, is able to break the continuous line of the scar. Assuming that it is possible to design the Z-plasty so that its central limb lies post-operatlvely on or parallel to a wrinkle the Z-plasty will have the effect of converting a long and relatively conspicuous scar Into a series of short and less conspicuous scars connected by lines (represented by each z-plasty central limb) lying In or parallel to the wrinkles. The method developed to enable the central limb to be placed with precision In terms of length, position and direction. Initially for the 60

• Item Type: Thesis (Ch.M)
• Qualification Level: Masters
• Additional Information: Adviser: Ian McKie
• Keywords: Medicine, Surgery
• Date of Award: 1971
• Depositing User: Enlighten Team
• Unique ID: glathesis:1971-72116
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 17 May 2019 12:56
• Last Modified: 17 May 2019 12:56
• URI: https://theses.gla.ac.uk/id/eprint/72116