Tetra-combined Z-plasty for wide-scar hip contracture including the anus

Extensive burns around the anus cause scarring and contracture, leading to difficulty in defecation due to anal stenosis and restriction of hip joint movement, which causes suffering to the patient. Conventional Z-plasty is not effective for widespread zonular scar contracture, and methods such as double combined Z-plasty and reversed Z-plasty have been developed. However, these methods are difficult to use because the position of the anus is displaced when the flap is moved.

The purpose of this study was to introduce a new technique to effectively release contracture in wide scars using tetra-combined Z-plasty, which has the following characteristics: 1. There is no deviation of the anus. 2. It prevents anal restenosis. 3. The funnel-shaped three-dimensional structure can be reconstructed.

These characteristics suggest that tetra-combined Z-plasty is also well-suited for the release of scar contracture in a wide range of skin landmark organs, including the perineum, penis, umbilicus, nipples, stoma, and tracheostomy.