The use of subcutaneous pedicle rhomboid flap in the treatment of postburn scar contractures

Purpose: To investigate the efficacy and versatility of subcutaneous pedicle rhomboid flap in the treatment of linear or wide postburn scar contractures located in various parts of the body. Materials and Methods: Twenty-three patients (aged 5 to 35 years) with postburn linear and wide scar contractures were treated with 31 subcutaneous pedicle rhomboid flaps. Rhomboid flaps were applied in the trunk (4 flaps), head and neck (5 flaps), lower extremity (5 flaps), and upper extremity (17 flaps). In 3 cases, Z-plasty was incorporated to the technique due to inadequate release. Results: All rhomboid flaps healed uneventfully. In 28 contractures, rhomboid flaps alone were efficient to release the tension line (90.3%). Tip necrosis of the triangular flaps of Z-plasty in 1 case was the only complication seen that later led to recontracture. Conclusion: Clinical results indicated that subcutaneous pedicle rhomboid flap is a simple, efficient, and versatile technique in release of any postburn scar contracture. As no undermining is carried out, the flaps are more reliable than commonly used Z-plasty. Again contrary to Z-plasty, displacement of anatomic landmarks such as axillary hair and areola is rare with the technique.