Chapter 22 - Famona Site

2. In general, the 60° Z-plasty is the most widly used, giving good lengthening anda reasonable margin of safety for flap survival.3. When facd with a long scar revision, multiple Z-plasties are preferable to large Z-plasties.4.A60°angle Z-plasty gives a 73% increase in scar length.C. Uses:1. To prevnt scar contracture.2. To change plane of scar.3. To reposition poorly placed tissue.4. To remove webbing.5. To close cutaneous defects.6. To remove "dog ears".7. To augment tissue.8. To correct defects at the commissure of the mouth, eye, etc.9. To enlarge a constricting tracheostome.Composite GraftsA. Definition: Graft which contains two layers of tissue, i.e. skin and cartilage.B. Uses: Ear, nose, eyelid, and trachea.C. Principles:1. Handle with care.2. Always use sharp instruments when taking a graft.3. Use no electrocautery to graft or vessel ligation.4. Never allow the periphery of the graft to be at a greater distance than 1.5 cm fromthe center. The length is irrelevant.5. Fine sutures (6-0) when suturing in place.8