26596 Excision of constricting ring of finger, with multiple Z-plasties

Name of the Procedure:

Excision of Constricting Ring of Finger with Multiple Z-Plasties

Summary

In this procedure, a surgeon removes tight bands of tissue around a finger that are causing restriction. They then use Z-plasty techniques to rearrange the skin and improve movement.

Purpose

The procedure addresses constrictive scar tissue or tight bands that limit finger movement or cause pain. The goal is to release the constriction, restore motion, and improve finger function.

Indications

• Presence of tight, constricting bands on the finger.
• Limited finger mobility or pain due to constriction.
• Scar tissue formation after injury or surgery.

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications, especially blood thinners, might need to be adjusted.
• Preoperative assessments may include physical exams and imaging studies.

Procedure Description

1. Anesthesia is administered, usually local, but sometimes general depending on patient and surgeon preferences.
2. The surgeon makes strategic incisions around the constricted area.
3. The tight band of tissue is excised.
4. Multiple Z-plasties are performed where small triangular flaps of skin are rearranged to cover the excised area.
5. The incisions are closed with sutures, ensuring minimal tension and improved flexibility.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is often performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the incision sites.
• Scarring or poor wound healing.
• Possible recurrence of constricting bands.
• Adverse reactions to anesthesia.
• Temporary or permanent nerve damage.

Benefits

• Improved finger movement and flexibility.
• Reduced pain and discomfort.
• Enhanced ability to perform daily tasks.

Recovery

• The finger is usually bandaged and may be splinted to protect the area.
• Patients are given instructions on wound care and activity limitations.
• Follow-up appointments are necessary to monitor healing.
• Recovery may take several weeks, with physical therapy often recommended to regain full motion.

Alternatives

• Non-surgical options like physical therapy, but these may not be effective for severe constrictions.
• Steroid injections, which can reduce inflammation but do not remove the constriction.
• Other surgical techniques, but Z-plasty is known for its effectiveness in improving functional and cosmetic outcomes.

Patient Experience

Patients may feel discomfort and tightness around the surgical site initially. Pain management is usually provided through medications. Swelling and bruising are common but gradually improve. Physical therapy may be required to enhance recovery and mobility.