Outcomes of Z-Plasty vs W-Plasty in Scar Revision for Post-Burn Contractures Among Iraqi Patients: A Prospective Comparative Clinical Study
Notice bibliographique
Résumé
Background: Post-burn scar contracture is a significant cause of disability in the long-run in Iraq, which is worsened by the inadequate access to reconstructive care and the impact of sociocultural factors. Z-plasty is a geometric flap method extensively applied in both functional and cosmetic restoration, but strong prospective evidence of its utilization in conflict-impacted, resource-limited areas is limited. Purpose: To compare the prospective functional, aesthetic, and patient-reported outcomes of Z-plasty, and W-plasty in the management of mature post-burn linear contracture in Iraqi patients. Methods: The study was a prospective cohort, 24 months, single center and site study based on Ghazi Al-Hariri Hospital, a Surgical Specialty Hospital, Baghdad ( January 2022-December 2023). Sixty eight individuals with mature (>6 months) linear contractures who had undergone a burn were randomly assigned as 1:1 to the Z-plasty and W-plasty group. The results were changes in the scar length, range of motion (ROM; assessed by goniometry), the Vancouver Scar Scale (VSS) scores, patient satisfaction (measured on a 5-point Likert scale), and the rates of complications at 6 months. Results: The mean age was 28.4/12.7 years; 57.4 was male. Flame burns contributed 64.7 percent to the injuries, and the displaced mean of surgery was 3.8 + 2.1 years. Z-plasty showed much better results in terms of cervical flexion ( +28.3 vs. +23.6, p = 0.04) and total VSS score ( –5.4 vs. - 4.8, p = 0.048) than W-plasty (see Tables 2 and 3). The scar length was 4.2 1.1 cm then 6.8 1.4 cm (p < 0.001); there was a significant improvement in ROM in all joints (Figure 5). The overall patient satisfaction was high (92.7% gave the outcomes as Good or Excellent), and the difference between groups in the case of patient satisfaction was not statistically significant (Table 4). There were no complications or flap necrosis or recurrence of contractures (Table 5) and the rates were low and similar (8.8% in both groups). Conclusion: Z-plasty is a safe and effective and contextually appropriate method of post-burn contracture release in Iraq with better functional outcomes in high tension areas like the neck and axilla. The two methods exhibit great safety profiles, but Z-plasty has better lengthening and scar repositioning capabilities, which are important in scarce health systems. The results are in favor of its inclusion into national guidelines on reconstructive surgery and surgical education programs.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,094 | 0,468 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,005 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,003 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,009 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».