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Julie Gustafson, MD; Wayne F. Larrabee, Jr, MD; Albert F. Borges, MD, FICS

Arch Otolaryngol. 1984;110(1):41-44.

Abstract
• Facial defects too large for primary closure can sometimes be repaired with the addition of a unilateral or bilateral adjunctive Z-plasty. In this study, the mechanics of the adjunctive Z-plasty are examined experimentally. In vivo experiments using piglets show that closure tension is decreased 30% by each Z-plasty. The true lengthening of the Z when transposed is 80% of that theoretically predicted. The deformation caused by fusiform excision and closure with and without undermining and with one or two Z-plasties is evaluated. In general, the Z-plasty exchanges deformation perpendicular to the long axis of excision for deformation parallel to that axis. A clinical case using the adjunctive Z-plasty for the repair of a large chin defect is reported.

(Arch Otolaryngol 1984;110:41-44)

Author Affiliations
From the Virginia Mason Research Center and Department of Otolaryngology, University of Washington (Dr Gustafson); the Section of Otolaryngology and Plastic Surgery (Dr Larrabee), the Mason Clinic, Seattle; and the Seven Corners Medical Building (Dr Borges), Falls Church, Va.

Footnotes
Accepted for publication June 22, 1983.

Reprint requests to Mason Clinic, 1100 Ninth Ave, Seattle, WA 98101 (Dr Larrabee).

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