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Related Experiment Videos

Trapdoor effect in nasolabial flaps. Causes and corrections.

F C Koranda, R C Webster

    Archives of Otolaryngology (Chicago, Ill. : 1960)
    |July 1, 1985
    PubMed
    Summary

    Scar contracture is the main cause of the trapdoor effect in nasolabial flaps. Treatments include Z-plasties and injections, with prevention through flap undermining.

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    Area of Science:

    • Plastic Surgery
    • Wound Healing

    Background:

    • The trapdoor effect is a scar deformity characterized by elevated, bulging tissue within a U-, C-, or V-shaped scar.
    • Several theories exist, including lymphatic/venous obstruction, scar hypertrophy, excess tissue, beveled edges, and scar contracture.

    Purpose of the Study:

    • To investigate the predominant cause of the trapdoor effect in nasolabial flaps.
    • To evaluate treatment modalities for trapdoor deformities.

    Main Methods:

    • Analysis of data to identify the primary cause of trapdoor deformities in nasolabial flaps.
    • Review of surgical techniques for correcting mild, moderate, and severe trapdoor deformities.

    Main Results:

    • Scar contracture was identified as the predominant cause of the trapdoor effect in nasolabial flaps.
    • Multiple small Z-plasties are indicated for mild to moderate deformities.
    • Intralesional triamcinolone acetonide injections may offer a "pharmacologic Z-plasty" effect.
    • Marked deformities require a combination of Z-plasties and peripheral undermining.
    • Prevention or reduction is achievable with adequate peripheral undermining of the flap recipient site.

    Conclusions:

    • Scar contracture is the primary driver of the trapdoor effect in nasolabial flaps.
    • Surgical interventions like Z-plasties and undermining are effective corrective measures.
    • Prophylactic undermining of flap recipient sites can mitigate or prevent trapdoor deformities.

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