[Release of amniotic constricted grooves by hemi-circumferential excision and skin closure without Z-plasty]

Constriction grooves are typical abnormalities of constriction band syndrome (CBS). Treatment by complete excision and Z-plastic closure is the gold standard for release of these grooves. However, the results of these Z-plasties are often judged to be aesthetically insufficient. The hypothesis was that direct excisional surgery without Z-plasty gave better aesthetic results. The objectives of this study were (1) to evaluate the clinicaal results of the release of amniotic furrows by simple hemi-circumferential excision without resorting to Z-plasties, (2) to study the occurrence of complications, (3) to study the factors leading to complications.

All patients who had release of amniotic grooves by linear hemi-circumferential excision and closure without Z-plasties were included between 2011 and 2017. Release of complete or circumferential grooves was carried out in 2 stages. Clinical evaluation was based on parental satisfaction with the aesthetic appearance and occurrence of any complications or recurrence.

Fourteen grooves including 8 circumferential and 6 semi-circumferential were released, in 7 patients. Average age at surgery was 9 months (3-18 months). Some patients had 1, 2 or 3 surgeries. The groove was localized in 7 cases in the leg, in 4 in the fingers and in 1 in the thigh, toes and forearm. At the last average follow-up of 25 months (12-41 months), all parents were very satisfied with the aesthetic appearance. No complications, including scarring, vascular or lymphatic disease, were noted. No recurrence was noted.

Release of amniotic grooves by simple linear hemi-circumferential excision without Z-plasties is a simple, safe and effective technique. The aesthetic results are very satisfactory.

IV - retrospective study.