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KMID : 0853020080110020131
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Journal of Korean Burn Society
2008 Volume.11 No. 2 p.131 ~ p.135
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The Use of Subcutaneous Pedicle Rhomboid Flaps in the Treatment of Postburn Scar Contractures in Joint Regions
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Yun Byung-Min
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Abstract
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Purpose: Various surgical techniques have been employed in the treatment of contracture bands, each with its own advantages and disadvantages. The author uses the subcutaneous pedicle rhomboid flaps which are relatively new in the treatment of scar contractures. This study investigates the use of this flap in joint regions particularly.
Methods: Three cases of linear and wide scar contracture(s) in joint regions were treated with subcutaneous pedicle rhomboid flaps. Rhomboid flaps were designed along the axis of the contracture line with 120- and 60-degree angles for the release of the contracture bands, and relaxation incision lines were marked. Rhomboid flaps were incised down to the muscle and freed from the surrounding skin. The emerged skin defects were then sutured with the flaps in V-Y advancement along the long axis and in Y-V advancement along the relaxation incisions.
Results: This flaps have three major advantages for the treatment of scar contractures in joint regions. Firstly, the technique is relatively free of distal necrosis when compared with triangular flaps in Z-plasty as no undermining is carried out. The broad subcutaneous pedicles of the flaps are very reliable. Secondly, the lengthening provided by this flaps is longer that a Z-plasty with 60-degree, which is the best angle to generate adequate central limb lengthening under equal tension. Lastly, the minimal distortion of the surrounding skin in this technique is more favorable to joint movements.
Conclusion: The subcutaneous pedicle rhomboid flaps can be chosen primarily for various types of postburn scar contractures in joint regions.
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KEYWORD
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Subcutaneous pedicle, Rhomboid flaps, Postburn scar contracture, Joint reconstruction
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