DOUBLE Z-PLASTY TO ENHANCE RHOMBIC FLAP MOBILITY

BACKGROUND. Occasionally after a rhombic flap has been designed, cut, and undermined, it fails to transpose into the recipient wound as easi ly as had been anticipated. This problem may have occurred because of unexpected skin tension due to previous surgery near the operative sit e or improper orientation of the rhombic flap. OBJECTIVE. The purpose of this work is to show how unexpected restriction in rhombic flap mov ement can be overcome by using a double Z-plasty to increase tissue le ngth. METHODS. A double Z-plasty was incorporated into the rhombic fla p design in one patient. The biomechanics of the flap were analyzed, a nd the modified flap was used in three other patients. RESULTS. The ad dition of a double Z-plasty increased the movement of the rhombic flap in a predictable fashion in four patients. CONCLUSION. A double Z-pla sty is useful to enhance rhombic flap mobility in certain uncommon sit uations.