Z-plasty is widely employed in plastic surgery and its mainly functions include elongation along the axis of the
scar, dispersal, and realigning the
scar within the lines of minimal tension. It is especially useful to release linear-
scar contracture, yet difficult for wide
scars. Here, we described a technique of
tissue expansion followed by serial Z-plasty for several cases of severe postburn
scar contracture. In this procedure, first, full expansion should be achieved in the tissues adjacent to the
contracture by
tissue expansion. Then, the serial Z-plasty technique with precise trimming and adjustment is performed with adequate tension-free skin to release the
contracture. Over a period of 2 years from 2015 to 2017, this technique was employed in moderate or severe postburn
scar contracture in four patients (1 male and 3 females) aged 14 to 40 years old. The size of
contracture ranged from 5 to 27 cm in diameter. Improved appearance and excellent skin match was observed in our four patients. All patients healed uneventfully without any complications and no patient required
revision surgery. The range of motion, short form-36 health survey and Vancouver
Scar Scale indicated that this technique offered a durable skin coverage with satisfying appearance in these patients. Through the outcomes of our patients,
tissue expansion followed by serial Z-plasty has a great potential to be a useful alternative for the treatment of
scar contracture especially for
contracture adjacent to cervical joints.