Shahwan Kathryn T, Amon Gabriel J, Archibald Laura K, Bakker Caitlin, Mattox Adam R, Alam Murad, Maher Ian A
University of North Dakota Medical School, Altru Health System, 3165 Demers Ave, Grand Forks, Grand Forks, ND, 58201, USA.
Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Arch Dermatol Res. 2023 Apr;315(3):443-446. doi: 10.1007/s00403-022-02373-9. Epub 2022 Aug 11.
Repair of auricular defects following tumor removal can be challenging. Many techniques have been described, but the literature lacks a comprehensive review of these methods. To perform a systematic review to compile and describe methods of reconstruction for post-surgical defects on the ears, eight databases were searched using terms related to ear anatomy, Mohs and excisions, and repair methods. Articles were eligible for inclusion if they contained repair data for ear defects following Mohs or excision for at least 4 subjects and were published in English between 2004 and 2019. Two reviewers screened all abstracts, and then evaluated the remaining full text articles to determine eligibility. The authors' specialties, study design, subject information, tumor and defect characteristics, procedure, repair methods, outcomes, and complications were then extracted. Most articles were written by dermatologic surgeons (66.7%). Repair methods included wedge excisions (19 cases), second intention healing (376), linear closures (294), purse strings (4), locoregional flaps (221), and grafts (2003). Most studies were small observational case series or cohort studies that lacked clear outcome measures. The available evidence on this topic is low quality. Further research utilizing improved study designs and standardized outcome measures is needed.
肿瘤切除术后耳廓缺损的修复具有挑战性。虽然已经描述了许多技术，但文献中缺乏对这些方法的全面综述。为了进行系统综述，以汇编和描述耳部手术后缺损的重建方法，我们使用了与耳部解剖、莫氏手术和切除术以及修复方法相关的术语，对八个数据库进行了检索。如果文章包含至少4例莫氏手术或切除术后耳部缺损的修复数据，并且在2004年至2019年期间以英文发表，则符合纳入标准。两名评审员筛选了所有摘要，然后评估了其余的全文文章以确定其是否符合条件。随后提取了作者的专业、研究设计、受试者信息、肿瘤和缺损特征、手术过程、修复方法、结果和并发症。大多数文章由皮肤科外科医生撰写（66.7%）。修复方法包括楔形切除术（19例）、二期愈合（376例）、直线缝合（294例）、荷包缝合（4例）、局部皮瓣（221例）和移植（2003例）。大多数研究是小型观察性病例系列或队列研究，缺乏明确的结局指标。关于这个主题的现有证据质量较低。需要利用改进的研究设计和标准化的结局指标进行进一步研究。
