Habiba Nazia U, Khan Arshad H, Khurram Mohammed F, Khan Mohammed Kamran
Department of Burns, Plastic and Reconstructive Surgery, JN Medical College, Aligarh Muslim University, Aligarh, UP-202002, India.
J Wound Care. 2018 Sep 2;27(9):564-572. doi: 10.12968/jowc.2018.27.9.564.
To evaluate the various methods and outcomes of post-traumatic partial auricle wound reconstruction, and to review the benefit to the patient's quality of life and their psychological improvement after the operation.
The prospective study included patients who suffered from post-traumatic partial auricular wounds. The defects were repaired using various techniques including simple local cutaneous advancement flaps, tube flaps, cartilage framework using conchal and costal cartilage with local skin flap cover.
A total of 18 patients were included, with a male predominance (sex ratio: 7:2), mean age with standard deviation of 31.66 ±9.27 years. Causes included road traffic accident (RTA), assault, human and insect bite and avulsion injuries. Injuries were sustained in the upper third of the auricle (n=8); middle third (n=5), lower third (n=3), and upper two-thirds (n=2). Out of the 18 patients, wound were repaired using post auricular mastoid skin flap (n=7); local superior and inferior chondrocutaneous flap (n=3); costal cartilage as a cartilage framework (n=4), temporoparietal fascia used to cover the costal cartilage graft (n=1), and conchal cartilage as a cartilage framework (n=3). In our study 13/18 patients were 'highly satisfied' with the aesthetic outcome, 3/18 were 'moderately satisfied', and 2/18 were 'slightly satisfied'. None were dissatisfied by the postoperative result. In terms of objective assessment, patient outcome in two patients was graded 'good' while the outcome of remaining patients (n=16) was graded as 'excellent'.
The use of skin flaps in the post-auricular region and the mastoid region associated with or without cartilage framework yields good cosmetic and functional result. The various techniques used for ear reconstruction yielded 100% satisfactory results in terms of functional outcome as well as boosting the confidence of patients.
评估创伤后部分耳廓伤口重建的各种方法及结果，并探讨手术对患者生活质量及心理改善的益处。
该前瞻性研究纳入创伤后部分耳廓伤口患者。采用多种技术修复缺损，包括简单局部皮瓣推进、皮管皮瓣、使用耳甲软骨和肋软骨作为软骨支架并覆盖局部皮瓣。
共纳入18例患者，男性居多（性别比：7:2），平均年龄为31.66±9.27岁。致伤原因包括道路交通事故（RTA）、袭击、人和昆虫叮咬及撕脱伤。损伤位于耳廓上1/3（n = 8）；中1/3（n = 5），下1/3（n = 3），以及上2/3（n = 2）。18例患者中，采用耳后乳突皮瓣修复伤口（n = 7）；局部上下软骨皮瓣（n = 3）；肋软骨作为软骨支架（n = 4），颞顶筋膜用于覆盖肋软骨移植体（n = 1），耳甲软骨作为软骨支架（n = 3）。在我们的研究中，13/18患者对美学效果“非常满意”，3/18“中度满意”，2/18“轻度满意”。无一例对术后结果不满意。就客观评估而言，2例患者的结果评为“良好”，其余患者（n = 16）的结果评为“优秀”。
耳后区域和乳突区域使用皮瓣，无论有无软骨支架，均可产生良好的美容和功能效果。用于耳部重建的各种技术在功能结果方面产生了100%的满意结果，同时增强了患者的信心。
