Kim Sang Wha, Park Chan Woo, Kim Jeong Tae, Kim Youn Hwan
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Craniofac Surg. 2012 Jan;23(1):57-60. doi: 10.1097/SCS.0b013e318240c908.
Conchal cartilage grafts are commonly used in rhinoplasties; however, complications related to the donor site, including delayed wound healing and scar formation and hematoma formation, still occur. Hematoma formation is the most important and frequent complication. Conventional tie-over dressing with a bolster has been commonly used to prevent donor-site hematomas, but it does not always give satisfactory outcomes. Therefore, we have introduced a new compressive dressing technique using Merocel, which is cut in half transversely: 1 piece is used as a posterior bolster and the other piece is cut in half again (yielding 2 small pieces) to make a concavity in the conchal cartilage (one piece for cymba concha and the other piece for cavum concha, respectively). After application of Merocel, the overall complication and hematoma formation rates were significantly decreased. Our new compressive dressing technique using Merocel has several advantages. Merocel can absorb more secretions and discharge from the operative site than conventional dressings and there are no risks of tissue necrosis or ischemia due to suture tension. Also, because Merocel can be freely cut and molded and applies even pressure, it can be used on irregular surfaces. Our new compressive dressing technique using Merocel is a simple and reliable option for preventing auricular hematomas.
鼻甲软骨移植常用于鼻整形手术；然而，与供体部位相关的并发症，包括伤口愈合延迟、瘢痕形成和血肿形成，仍然会发生。血肿形成是最重要且最常见的并发症。传统的带有支撑物的包扎敷料常用于预防供体部位血肿，但效果并不总是令人满意。因此，我们引入了一种使用美罗赛（Merocel）的新型压迫包扎技术，将美罗赛横向切成两半：一块用作后部支撑物，另一块再切成两半（得到2小块），在鼻甲软骨上形成一个凹陷（一块用于耳甲艇，另一块用于耳甲腔）。应用美罗赛后，总体并发症和血肿形成率显著降低。我们使用美罗赛的新型压迫包扎技术有几个优点。与传统敷料相比，美罗赛能吸收更多来自手术部位的分泌物和排出物，且不存在因缝线张力导致组织坏死或缺血的风险。此外，由于美罗赛可以自由切割和塑形并施加均匀压力，它可用于不规则表面。我们使用美罗赛的新型压迫包扎技术是预防耳廓血肿的一种简单可靠的方法。
