Knowledge of Fusiform, Z-Plasty Aids New Mohs Surgeons


The three transposition flaps most often discussed and used by dermatologic surgeons are the Limberg, Webster, and Dufourmentel flaps.

The only difference among them is the total angle of the z-plasties used to create the flaps. The larger the sum of the total angles of the z-plasty of the transposition flap, the greater the lengthening and degree of rotation of the central limb and the greater the shortening of tissue in the opposite axis.

These actions result in the movement of tissue into the defect known as a transposition flap closure. Overall, the amount of tissue that is "wasted" is similar in both a z-plasty and a rotation flap, Dr. Gross said.


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