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CC BY 4.0 · Arch Plast Surg 2024; 51(01): 126-129
DOI: 10.1055/a-2189-9767
Extremity/Lymphedema
Idea and Innovation

The Square-Plus Flap: A Modification to Release Long Postburn Scar Contractures

Mahmoud A. Hifny 
1   Department of Plastic Surgery, Faculty of Medicine, Qena University Hospital, South Valley University, Qena, Egypt
,
Rei Ogawa 
2   Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
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Abstract

The square flap method has been successful in releasing contracture bands at various body regions. However, the original square flap method alone may not be efficient in releasing long contracture bands. We, therefore, proposed an extended design to the traditional design, which is called the “square-plus flap.” A 4-year-old girl presented with a postburn web-like contracture band over the right axilla. We marked a square flap technique at the center of the contracture band and then two additional Z-plasties were placed on both edges of the flap. After the release and securing of the square flap, the adjacent distal Z-plasty was then transposed and sutured in their new locations. We do not need to incise the proximal Z-plasty as we could achieve complete relaxation of the contracture band. This novel modification can be added to the plastic surgeon's armamentarium for releasing long postburn contracture bands involving distinct body regions.

Keywords

square flap - Z-plasty - burn - contractures - scar

Authors' Contributions

M.A.H. was responsible for conceptualization, acquisition of data, analysis and interpretation of data, and drafting and revising the article. R.O. was responsible for drafting and revising the article. Both the authors read and finally approved of the version to be published.


Patient Consent

Written and informed consent was obtained from patient.




Publication History

Received: 19 April 2023

Accepted: 07 October 2023

Accepted Manuscript online:
11 October 2023

Article published online:
07 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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