This training module will explore the Z-Plasty surgical technique, which is a form of local random pattern flap that can be used for many forms of reconstructive surgery. The z-plasty is a well-known flap to plastic and reconstructive surgeons due to its highly adaptable and essential role in reconstructing defects and deformities due to burns, trauma, cancer, infections, and congenital conditions. The information and links below can be used to go through the training module to acquire the critical background knowledge, take self-assessment tests, construct and utilize the physical simulator, and link to the virtual simulation app.
Learning Objectives: Z-Plasty Module[edit | edit source]
- The trainee will understand the essential components of designing the Z-plasty.
- Relaxed Skin Tension Lines & Skin Laxity
- Central & Lateral Limb Orientation, Lengths, & Angles
- The trainee will be able to clearly define the Four Functions of the Z-plasty.
- The trainee will understand the Indications for Z-plasty and which clinical scenarios to apply it.
- The trainee will be able to accurately describe all Steps of the Procedure (marking, incision, dissection/elevation, transposition, closure).
- The trainee will know how to modify the design of the flap as well as when to use multiple Z-plasties to address different size scars, different regions of the body, and different tissue availability.
- The trainee will appreciate the limitations of the Z-plasty.
- The trainee will understand the pearls and pitfalls of the procedure.
- The trainee will know the possible complications that may arise intra-operatively and post-operatively as well as the appropriate management for them.
Course Syllabus[edit | edit source]
Phase 1: Foundation of Knowledge[edit | edit source]
The most challenging part of performing any surgical reconstruction using local flaps like a Z-Plasty is the foundational knowledge that is required to understand when to use this technique, how to adapt it to specific clinical situations, and where this surgical technique falls within the broader reconstructive repertoire. As a result, the background knowledge (Phase 1) is critical to master prior to proceeding to the physical simulator (Phase 2 & 3). The learner should closely study the content of these pages in order to learn the necessary background and foundation of knowledge that is pertinent to the Z-Plasty Procedure. Once these pages and the accompanying information are reviewed, proceed to take the readiness test. It is highly recommended that the learner be familiar with this content before proceeding to the physical simulator.
All of the information from Phase 1 including the educational content, instructional videos, and self assessments are contained on a free, interactive app (link here) that includes the following components:
- AmoSmile App Contents
- Z-Plasty Foundational Knowledge
- Background information on Reconstructive Ladder, Flap Classifications, & Relevant Anatomy
- Step-by-step Walk-through
- Interactive, tactile Z-Plasty Simulator
- Dynamic Self-Assessment tools
- Instructions & example videos of the physical simulator build & walk-through
- Assessment form for physical simulator
- Feedback form for app
After downloading the AmoSmile app and creating your unique username, take the pre-module assessment to identify your baseline understanding of the core concepts that will be taught in this module.
All educational content is available both through the Appropedia website as well as our AmoSmile app which has additional interactive features and real-time feedback.
- Thinking Like a Reconstructive Surgeon: The Reconstructive Ladder/Elevator
- Flap Classifications & Relevant Anatomy
- Z-Plasty Background
Once all of the educational content has been studied, take the post-module assessment on the AmoSmile app to identify readiness to proceed onto the physical simulator. (It is important to master this material prior to advancing to the physical simulator in order to maximize the educational benefit of the psychomotor skill training.)
Phase 2: Physical Simulator Skills Practice[edit | edit source]
Following completion of Phase 1, proceed with building and practicing on the physical simulator. The individual steps for Phase 2 are outlined below.
Once the step-by-step walk-through for the physical simulator has been completed, use the AmoSmile app to fill out the self-directed assessment tool for skill acquisition.
Phase 3: Review & Repeat[edit | edit source]
Repetition is the key to successfully acquiring any new skill or knowledge. This training module is designed with a dynamic, customized self-assessment system that generates additional questions and increases difficulty as your competency grows. After completing the physical simulator and the associated assessment tool, take that feedback and go back to the AmoSmile app, where you can review the specific aspects of the procedure that were challenging or where additional questions arose during the simulation process. The competency tracking system will help guide you through the educational content as your mastery of the material improves.