Kim Yun Jung, Min Kyunghyun, Kim Young Seok, Roh Tai Suk, Zhang Hyun-Soo, Yun In Sik
Department of Plastic and Reconstructive Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea.
Arch Craniofac Surg. 2024 Aug;25(4):179-186. doi: 10.7181/acfs.2024.00444. Epub 2024 Aug 20.
Auricle reconstruction is among the most challenging procedures in plastic and reconstructive surgery, and the choice of framework material is a critical decision for both surgeons and patients. This meta-analysis compared the outcomes of autologous auricle reconstruction using costal cartilage with those of alloplastic reconstruction using porous polyethylene implants.
A literature review was conducted using the PubMed and Embase databases to retrieve articles published between January 2000 and June 2024. The outcomes analyzed included postoperative complications such as framework exposure, infection, skin necrosis, hematoma, and hypertrophic scars, as well as patient satisfaction. The proportions of reconstructive outcomes from each selected study were statistically analyzed using the "metaprop" function in R software.
Fourteen articles met our inclusion criteria. The group undergoing polyethylene implant reconstruction exhibited higher rates of framework exposure, infection, and skin necrosis, whereas the autologous reconstruction group experienced higher rates of hematoma and hypertrophic scars. Of all the complications, framework exposure was the only one to show a statistically significant difference between the two groups (p < 0.0001). In terms of patient satisfaction, those who underwent autologous cartilage reconstruction reported a higher rate of satisfaction, although this difference did not reach statistical significance in the meta-analysis (p = 0.076).
There is no statistically significant difference in postoperative complications such as infection, hematoma, skin necrosis, and hypertrophic scars between auricle reconstructions using autologous costal cartilage and those using polyethylene implants. However, reconstructions with polyethylene implants show a significantly higher rate of framework exposure.
耳廓再造是整形与重建外科中最具挑战性的手术之一，而支架材料的选择对外科医生和患者来说都是关键决策。本荟萃分析比较了使用肋软骨进行自体耳廓再造与使用多孔聚乙烯植入物进行异体材料再造的效果。
利用PubMed和Embase数据库进行文献综述，以检索2000年1月至2024年6月发表的文章。分析的结果包括术后并发症，如支架外露、感染、皮肤坏死、血肿和增生性瘢痕，以及患者满意度。使用R软件中的“metaprop”函数对每项所选研究的重建结果比例进行统计分析。
14篇文章符合我们的纳入标准。接受聚乙烯植入物重建的组支架外露、感染和皮肤坏死的发生率较高，而自体重建组血肿和增生性瘢痕的发生率较高。在所有并发症中，支架外露是两组之间唯一显示出统计学显著差异的并发症（p < 0.0001）。在患者满意度方面，接受自体软骨重建的患者报告的满意度较高，尽管在荟萃分析中这种差异未达到统计学显著性（p = 0.076）。
使用自体肋软骨进行耳廓再造与使用聚乙烯植入物进行耳廓再造在感染、血肿、皮肤坏死和增生性瘢痕等术后并发症方面没有统计学显著差异。然而，使用聚乙烯植入物进行的再造显示出显著更高的支架外露率。
