Difficulties with running V-Y plasty in releasing burn scar contracture

BACKGROUND Many approaches to the release of burn contracture have been described. Each offers some advantages for the treatment of contractures, but they have some limitations affecting their indications and outcomes. In this study, we attempt to describe clearly the difficulties with running V-Y plasty after our experience with this technique. METHODS This study included 21 patients with scar contracture. Pre-operatively, for marking the flaps, a zigzag line, the angles of which were kept in the range of 60-90 degrees, was drawn over the contracture line. The incision was firstly made into the skin to avoid retraction of the flaps, and then deep through the fascia, making advancement of the V flap easy by sliding. The V flap was advanced along the long limb of the Y on the base of a subcutaneous pedicle. After meticulous hemostasis, all incisions were sutured. RESULTS In most of the patients, successful release of the contracture was achieved without any complication. However, in a few cases, some challenging problems developed, suggesting possible limitations of the running V-Y plasty procedure. CONCLUSION When considering running V-Y plasty for the release of contracture, awareness of the related difficulties will be helpful and will facilitate selection of the cases suitable for the procedure to achieve successful results and avoid possible complications.