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The Four Fundamental Functions of the Z-Plasty

David W. Furnas, MD
Arch Surg. 1968;96(3):458-463. doi:10.1001/archsurg.1968.01330210136027.
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THE Z-plasty is an effective weapon in surgical forays against a multitude of defects upon and beneath the body surface.1,2 Fundamentally, a Z-plasty may perform any (or all) of four functions, which are (1) to increase (or decrease) length, (2) to break up a straight line, (3) to shift topographic features from one site to another, and (4) to efface or to create a web or a cleft. In a figurative sense, the first three functions take place on a single plane and are two dimensional, whereas the fourth function involves two separate planes and is three dimensional.

Lengthening (Fig 1 and 2).  —When a bri dle-like contracture steals length and robs function, the problem can be solved by paying normal (or at least extensible) tissue into the defect through a Z-plasty or a series of Z-plasties. The central limb of the Z is plotted along the line of


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