Our Summary

This research paper investigates the effectiveness of two surgical procedures, 5-flap z-plasty and double z-plasty, for treating post-burn or post-trauma interdigital pocket web contractures, a condition that stiffens the skin between the fingers. The research involved 16 cases in 11 patients. The results showed that both procedures improved the mobility of the fingers, but the 5-flap z-plasty resulted in a greater angle of finger movement and a greater decrease in the slope of the skin between the fingers, suggesting it may be the better option for treating this condition. All patients reported no pain or discomfort and were able to actively move their fingers after the surgery.

FAQs

  1. What are the 5-flap z-plasty and double z-plasty procedures used to treat?
  2. Which of the two surgical procedures showed better results in improving the mobility of fingers?
  3. Were there any reports of pain or discomfort from patients after undergoing these surgical procedures?

Doctor’s Tip

A doctor might advise a patient undergoing z-plasty surgery to follow post-operative care instructions carefully, including keeping the surgical site clean and dry, taking prescribed medications as directed, and attending follow-up appointments to monitor healing and ensure optimal outcomes. It is also important for the patient to follow any physical therapy or rehabilitation recommendations to maximize the benefits of the procedure and regain full functionality of the affected area.

Suitable For

Patients who may be recommended for a z-plasty procedure include those with:

  • Post-burn or post-trauma interdigital pocket web contractures
  • Scar contractures that limit movement or function
  • Hypertrophic or keloid scars that are causing discomfort or aesthetic concerns
  • Skin grafts that have resulted in tight or restricted movement
  • Congenital anomalies or malformations that affect the skin or underlying tissues

It is important for patients to undergo a thorough evaluation by a plastic surgeon or dermatologist to determine if a z-plasty procedure is the best course of treatment for their specific condition.

Timeline

Before z-plasty:

  • Patient presents with post-burn or post-trauma interdigital pocket web contractures
  • Skin between fingers is stiff and immobile
  • Patient may experience pain or discomfort when trying to move fingers
  • Limited range of motion in affected fingers
  • Difficulty performing daily activities that require the use of fingers

After z-plasty:

  • Patient undergoes either 5-flap z-plasty or double z-plasty procedure
  • Surgery improves mobility of fingers by releasing the contracted skin between fingers
  • 5-flap z-plasty results in greater angle of finger movement and decrease in slope of skin between fingers
  • Patient experiences no pain or discomfort post-surgery
  • Patient is able to actively move fingers and perform daily activities with improved range of motion and function

What to Ask Your Doctor

  1. What is z-plasty and how does it work to improve mobility in the fingers?
  2. What are the potential risks and complications associated with undergoing a z-plasty procedure?
  3. How long is the recovery period after a z-plasty procedure and what can I expect during the healing process?
  4. Are there any specific post-operative care instructions I should follow to ensure the best outcome from the surgery?
  5. How many z-plasty procedures have you performed for treating interdigital pocket web contractures, and what is your success rate with this technique?
  6. Are there any alternative treatment options available for my condition, and how do they compare to z-plasty in terms of effectiveness and recovery time?
  7. Will I need physical therapy or rehabilitation after undergoing a z-plasty procedure, and if so, what will that involve?
  8. What is the long-term outlook for my mobility and function in the affected fingers after undergoing a z-plasty procedure?
  9. Are there any factors that may affect my eligibility for z-plasty surgery, such as underlying health conditions or medications I am currently taking?
  10. Can you provide me with any before-and-after photos or case studies of previous patients who have undergone z-plasty for interdigital pocket web contractures?

Reference

Authors: Yang C, Yang Y, Zhong W, Li B, Li F. Journal: J Hand Surg Am. 2024 Oct;49(10):1033.e1-1033.e7. doi: 10.1016/j.jhsa.2022.11.011. Epub 2023 Jan 7. PMID: 36623947