TY - JOUR ID - 101985 TI - Comparing Z-Plasty versus Z-Plasty and Skin Grafting for Surgical Tension-Free Treatment of Post-Burn Elbow Contractures: A Randomized Clinical Trial JO - Trauma Monthly JA - TM LA - en SN - 2251-7464 AU - Seyed Nejat Hosseini, Seyed Nejat Hosseini AU - Khorram, Mehran AU - Vakili, Masoud AU - Samani, Farnaz AD - AD - Department of Burns Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran AD - Department of Health Education and Promotion, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran AD - Department of Anesthesiology, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran Y1 - 2019 PY - 2019 VL - 24 IS - 2 SP - 1 EP - 5 KW - Z-Plasty KW - Skin Graft KW - Elbow Contracture KW - Post-Burn Contracture DO - 10.5812/traumamon.82921 N2 - Background: Elbow contracture is a common incidence. It has surgical treatments such as scar release and skin graft, Z or V-Y plasty, and lateral or medial arm flap. In this study, we compared Z-plasty versus Z-plasty and skin grafting in the surgical tensionfree treatment of post-burn elbow contractures.Methods: 30 patients with elbow joint extension restriction participated in this randomized clinical trial in two groups: experimental (Z-plasty with skin graft) and control (Z-plasty alone) groups. In both groups, Z-plasty was designed with a 60 angle. In the experimental group, the flaps were rotated without tension, and then the upper and lower parts of the flaps were grafted by a midsplit-thickness skin graft. The surgery area was examined regarding infections, wound healing time, necrosis, and scar. Significant differences were evaluated using unpaired student t-test.Results: Only seven participants in the control group had complications. The statistical analysis of all variables in both groups showed that Z-plasty with skin graft treatment had a significantly better result than the Z-plasty alone (P = 0.006). However, the two groups showed no significant differences in terms of infection, flap tip necrosis, surgery site infection, and feeling of pressure in joint extension or scar recurrence (P = 0.273).Conclusions: Tension-free flap must be used in patients with mild or moderate wide elbow scar contracture. Combining Z-plasty with skin graft is easy and has better results than Z-plasty alone. It is recommended using this technique in patients with intraoperative flap tension. UR - https://www.traumamon.com/article_101985.html L1 - https://www.traumamon.com/article_101985_c8ca4db0dc21f3fca29836aec57d8353.pdf ER -