Management of hypertrophic scars on the pubic area with an iliac flap

Rhomboid flap with multiple Z-plasty for treatment of hypertrophic scar on the pubic area

The pubic area is prone to the development of hypertrophic scars; however, few studies have reported on the valid means of treating hypertrophic scars affecting this area. We have recently devised a new operative procedure, 'rhomboid flap with multiple Z-plasty', for the treatment of this condition. For this operative procedure, the defect after resection of the scarred tissue in the pubic area is first covered with a rhomboid flap elevated from the hypogastric area, followed by applying multiple Z-plasty to the suture wound of the donor site. By avoiding excessive suturing of the defect in the pubic area, and by covering the defect with a rhomboid flap, the tension on the wound margin can be sufficiently reduced. This is followed by multiple Z-plasty for the longitudinal wound of the hypogastric area, erasing all suture lines perpendicular to the natural folds. Here, we report two cases that underwent this procedure with favourable outcomes.