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A Geometric Exploration of the Z-Plasty

Galen S. Wachtman, MD, Jason H. Neiss, BS, Ernest K. Manders, MD
University of Pitsburgh
2012-02-16

Presenter: Galen Wachtman

Affidavit:
100%

Director Name: Joseph E. Losee, MD

Author Category: Chief Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

How does this presentation meet the established conference educational objectives?
The presentation provides a geometric basis to a commonly estimated result in plastic surgery.

How will your presentation be used by practicing physicians in the audience?
It will further their understanding of the z-plasty operation.

A Geometric Exploration of the Z-Plasty

Galen S. Wachtman, MD, Jason H. Neiss, BS, Ernest K. Manders, MD

Background: The z-plasty is a commonly used method for tissue transposition in plastic surgery. Traditionally, the amount of length gained for z-plasties of different angles has been estimated heuristically. Here, we present a simple formula for deriving the length gain for z-plasty.

Methods: Geometric and trigonometric analysis of z-plasties of different angles allowed the derivation of a concise formula for length gain of z-plasty, generalizable from angles 0 to 90 degrees.

Results: For z-plasties with identical limb length x and angle between the limbs of :

Length l=x(5-4cos ) for all angles 0 < < 90.

Conclusions: A concise equation for the length gained for Z-plasties was derived. The most common angle for z-plasty has been 60 degrees and has a commonly quoted length gain of 75%. Using our formula, the length gain is predicted to be 1.73 (3), or a 73% gain in length. This formula can be used to accurately predict the length gained for z-plasties of commonly usable angles, and provides for an understanding of the length gained using simple geometric principles.

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