Subha Dhua1, Subramani S. A2
Denonvilliers in 1856 was the first one to describe Z-plasty technique as a surgical correction for lower lid ectrpion and it was McCurdy who made the first reference to this technique in the American Literature in 1913 for treatment of contracture at the oral commissure. In 1929 Limberg came up with a more geometric description but geometric details showing optimal angles and length were provided by Davis in 1946.1 Z-Plasty is one of the most versatile and widely used technique after number of modifications namely multiple serial,2 four-flap,3 fiveflap,4,5 and six-flap,6 double-opposing Z-plasties, and other, less commonly used modifications.7,8 These are not just theoretical extensions of the Z-Plasty, but practical and applicable procedures. Z-plasty was chosen in our studies to release contracture of the neck scar. In our case we have performed the release of contracture of the neck for improving functional and cosmetic appearance of post burn contracture of the neck. Through multiple Z-plasty technique without excision of Supple Scar, it is possible to lengthen the contracted scars due to burns through changing the direction of the scar. This technique has helped to interrupt and break the scar for better camouflage. The paper describes correction of 20 post burn cases of scar contracture in the neck. The majority of the cases happen to be female who sustained flame burns while cooking. The major disability of limitation was of neck movement as well as of the lower jaw was effectively addressed through this technique by creating longer final gain in length of the contracted scar. The final results obtained by changing the direction of the scar and aligning it with the skin tension lines gave excellent camouflage and cosmetically acceptable outcome. This technique has given the following advantages: Achieve good extension of the neck to normal. There is no chance of recurrence of contracture of neck.
