๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
HISTORICAL PERSPECTIVES
HISTORICAL PERSPECTIVES
Introduction of the Z-plasty dates back several centuries.1 In the early 1800s, Fricke and Horner described single transposition flaps, the fundamental basic subunit of the Zplasty. In his 1837 clinical report, Dr. William Horner illustrated its use for ectropion repair.2 Later, Serre and Denonvilliers were invoking its use for facial reconstruction.3,4 In 1904, Berger exchanged triangular flaps of equal size and equal angles for axillary web contracture correction, performing the first double transposition Z-plasty 9 years before the term โZ-plastyโ was used.5 In 1913, McCurdy published a paper entitled, Zplastic surgery: plastic operations to elongate cicatricial contractions of the neck, lips and eyelids and across joints.6 Later, variations of the Z-plasty arose to include multiple Z-plasties, proposed by Morestin in 1914, for the treatment of retracting scars of the hand.7
Limberg expounded on the mathematical basis of the technique, delineating nuances previously ambiguous to many in his handbook for surgeons published in 1963.8 This work explained with two-dimensional models the movement of flaps and the reaction to their action in the adjacent tissue. Defining the geometric principles of the basic Zplasty technique, he wrote: โGeometrical selection of symmetrical forms of convergent triangular flaps shows decrease in width and growth in length at the ends of the
diagonals.โ8 Its biomechanics was further refined by McGregor, who applied the law of cosines to the inherent foundation of the Z-plasty design which is utilized today.9