Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhi Zao Ju Rd., Shanghai, 200011, China.
Aesthetic Plast Surg. 2020 Oct;44(5):1545-1552. doi: 10.1007/s00266-020-01711-4. Epub 2020 Apr 16.
Skin grafts, frequently used for ear elevation in ear reconstructions, may suffer from color mismatches, scar hypertrophy, secondary contraction, and auricular sulcus depth differences. To determine the most suitable donor area, we compared the contralateral postauricular area, groin, and scalp as potential donor sites.
Since 2008, we have used three donor sites for obtaining skin grafts used in ear reconstructions. Full-thickness groin skin, split-thickness grafts from the scalp, and contralateral postauricular and groin composite full-thickness skin grafts were used in 202, 231, and 195 patients, respectively. Photographic assessments were used to assess color matching, sulcus depth, cranioauricular angle symmetry, and flatness of the skin grafts; surgical complications were also documented.
Among the three donor sites, there were no significant differences in the color matching scores (p = 0.456). The scalp donor scores had significantly lower mean scores for sulcus depth and symmetry and for graft flatness scores than the other donor sites. The assessment scores between the groin and postauricular donor groups were similar. Each donor site was associated with some surgical complications. However, postauricular skin, when combined with groin skin, demonstrated the best cosmetic results and the fewest complications.
All three donor sites are viable options for skin graft donor sites in ear elevation surgeries. Although the advantages and disadvantages of each site should be explained to the patient, the ultimate donor site selection may be determined according to patient and surgeon preferences.
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皮瓣移植常被用于耳再造术中的耳朵抬高，但是可能会有色差匹配不良、瘢痕增生、二次收缩和耳轮沟深度差异等问题。为了确定最合适的供区，我们比较了对侧耳后区、腹股沟和头皮作为潜在供区。
自 2008 年以来，我们使用三种供区获取用于耳再造的皮瓣。全厚腹股沟皮瓣、头皮部分厚度皮片和对侧耳后区和腹股沟复合全厚皮瓣分别用于 202、231 和 195 例患者。采用照片评估来评估颜色匹配、耳轮沟深度、颅耳角对称性和皮瓣平整度；还记录了手术并发症。
在三个供区中，颜色匹配评分没有显著差异（p=0.456）。头皮供区的耳轮沟深度、对称性和皮瓣平整度评分的平均得分明显低于其他供区。腹股沟和耳后供区组之间的评估评分相似。每个供区都与一些手术并发症相关。然而，耳后皮瓣与腹股沟皮瓣联合使用时，表现出最佳的美容效果和最少的并发症。
所有三个供区都是耳抬高手术中皮瓣供区的可行选择。虽然应向患者解释每个部位的优缺点，但最终的供区选择可能取决于患者和外科医生的偏好。
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