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Sheet of scar causes trapdoor deformity: a hypothesis
K Hosokawa1, T Susuki, T Kikui
1Department of Plastic Surgery, Sumitomo Hospital, Osaka, Japan.
Annals of Plastic Surgery
|August 1, 1990
Summary
Internal scarring, not just surface scars, is proposed as the main cause of the trapdoor deformity. This finding suggests new ways to understand and treat this condition.
Area of Science:
- Plastic surgery
- Dermatology
- Wound healing
Background:
- The trapdoor deformity is a recognized complication following certain surgical procedures.
- Previous understanding attributed the deformity to the contraction of external, semicircular skin scars.
Purpose of the Study:
- To propose a new hypothesis regarding the primary cause of the trapdoor deformity.
- To challenge the existing theory on the etiology of the trapdoor deformity.
Main Methods:
- Review of clinical observations and existing literature.
- Formulation of a new etiological hypothesis based on scar tissue mechanics.
Main Results:
- The study hypothesizes that a sheet of internal scar tissue, rather than the superficial skin scar, is the principal factor in elevating the skin within the scar's semicircle.
- This internal scar contraction exerts a downward and inward pull, leading to the characteristic deformity.
Conclusions:
- The trapdoor deformity may be primarily driven by sub-dermal scar contraction.
- This revised understanding could influence surgical techniques and post-operative management to prevent or correct the deformity.