Evidence map›Paper›PMID 40634762›Full record

SynthesisAesthetic plastic surgery2025

Treatment of Trapdoor Deformity After Facial Skin Flap Reconstruction.

Gianmarco Polverino, Francesca Russo, Francesca Mosella, Francesco Mazzarone, Francesco D'Andrea

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Aesthetic plastic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Gianmarco PolverinoUnit of Plastic Surgery, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy. gianmarcopolverino94@gmail.com.ORCID 0009-0000-4353-9047
Francesca RussoUnit of Plastic Surgery, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.
Francesca MosellaUnit of Plastic Surgery, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.
Francesco MazzaroneDepartment of Plastic & Reconstructive Surgery, Hospital Santa Casa de Misericórdia do Rio de Janeiro, 38th Infirmary Professor Ivo Pitanguy's Service, Rio de Janeiro, Brazil.
Francesco D'AndreaUnit of Plastic Surgery, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe trapdoor deformity is a common postoperative complication characterized by bulging tissue within a depressed, semicircular scar, often seen after reconstructive procedures with curved flaps. It results from complex physiomechanical forces, including scar contraction vectors, tissue bunching, lymphatic or venous obstruction, and excess subcutaneous fat. Despite various theories, its exact pathophysiology remains unclear. Traditional treatments like Z-plasties and peripheral undermining aim to redirect contraction forces, though recurrence is frequent. Emerging research explores lymphatic dysfunction as a contributing factor. This study systematically reviews all flap types associated with trapdoor deformity and evaluates both current and emerging management strategies. MATERIALS AND

methodsA systematic literature review on trapdoor deformity was conducted following PRISMA guidelines, using PubMed, Scopus, and Web of Science. Inclusion criteria covered original clinical studies on trapdoor deformity treatment and prevention in facial flaps, while reviews, unclear reports, and animal studies were excluded. Two investigators independently extracted data, with a third reviewer resolving discrepancies. Both English and select non-English articles were analyzed.

resultsOut of 1864 screened citations, 867 duplicates and 898 irrelevant articles were excluded, leaving 99 for full-text review. Fifty met inclusion criteria, reporting 521 trapdoor deformity cases from 1982 to 2024. The bilobed and nasolabial flaps were most associated with TD, especially in nasal reconstruction. Only 12 of the included studies focused on treatment as the primary endpoint.

conclusionTriamcinolone injections are an effective first-line treatment. Laser therapy shows potential and warrants further research, whereas super shaving lacks robust data on long-term outcomes and complication. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

Indexed as

CicatrixPlastic Surgery ProceduresPostoperative ComplicationsSkin TransplantationSurgical FlapsEstheticsFemaleHumansMaleRisk AssessmentTreatment OutcomeFacial reconstructionFlapMohs surgeryPincushioningSkinTrapdoor deformity

Identifiers

PMID40634762

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.