Department of Dermatology, Venereology and Allergology. Academic Teaching Department of Medical University Innsbruck, Central Teaching Hospital Bolzano/Bozen, Bolzano/Bozen, Italy.
Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital of St. John of God Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria.
J Dtsch Dermatol Ges. 2018 Feb;16(2):163-173. doi: 10.1111/ddg.13415. Epub 2018 Jan 12.
Surgical reconstruction following the removal of large malignant auricular lesions is challenging. While many options for defect closure have been described, in the elderly population usually affected flap surgery, long anesthesia times, patient compliance, and anticoagulant therapy pose additional risks. An alternative quick, simple, and effective method of defect closure is therefore highly desirable. The objective of the present study was to assess the aesthetic outcome, healing process, complications, and recurrence rates associated with unmeshed split-thickness skin grafts (STSGs) used for covering large auricular skin defects following cartilage-sparing skin cancer removal.
Under local tumescent anesthesia, 32 patients received STSGs for defect closure following the removal of malignant cutaneous neoplasms of the ear.
The average defect size was 8.0 cm². In all cases, complete healing of the recipient site occurred within two weeks. There were no major complications. The aesthetic outcome was rated highly by patients as well as by the dermatosurgeon involved and two independent plastic surgeons.
STSGs are a valid option for closing large auricular skin defects. Even large cutaneous tumors of the external ear do not necessarily infiltrate the cartilage. Thus, cartilage-sparing tumor resection with subsequent defect closure using a STSG is an excellent and quick method associated with high patient satisfaction.
切除大型恶性耳廓病变后的外科重建具有挑战性。虽然已经描述了许多用于关闭缺损的方法，但在老年人中，通常会采用皮瓣手术，这会增加手术时间、患者配合度以及抗凝治疗等风险。因此，人们非常希望有一种快速、简单且有效的方法来关闭缺损。本研究的目的是评估游离刃厚皮片（STSG）用于覆盖耳软骨保留型皮肤癌切除术后大型耳廓皮肤缺损的美学效果、愈合过程、并发症和复发率。
在局部肿胀麻醉下，32 名患者接受游离刃厚皮片用于恶性皮肤肿瘤切除术后的缺损覆盖。
平均缺损大小为 8.0cm²。所有病例的受区均在两周内完全愈合，无重大并发症。患者、参与手术的皮肤科医生以及两位独立的整形外科医生均对美学效果评价很高。
游离刃厚皮片是关闭大型耳廓皮肤缺损的有效选择。即使是外耳的大型皮肤肿瘤也不一定会侵犯软骨。因此，保留软骨的肿瘤切除后，采用游离刃厚皮片进行缺损覆盖是一种极好且快速的方法，患者满意度高。
