Meira Pazelli Alexandre, Gates-Tanzer Lauren, Willborg Brooke E, Srikumar Jainaha K, Mardini Samir, Sharaf Basel, Bite Uldis, Gibreel Waleed
From the Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.
Ann Plast Surg. 2025 Jun 1;94(6):653-657. doi: 10.1097/SAP.0000000000004325.
The management and use of antibiotics in pediatric ear lacerations lacks standardization. This study sought to provide a comprehensive review of these injuries and assess the impact of administering perioperative antibiotics on the incidence of infections after repair.
Retrospective review of all pediatric ear lacerations treated at our institution's emergency department (ED) between 1998 and 2024.
A total of 246 patients (177 boys) were included. Patients aged 0-6 years were most affected (n = 117, 47.6%), with the peak between 2-5 years old (n = 78, 31.7%). Most lacerations were superficial (n = 145, 58.9%), followed by intermediate (n = 62, 25.2%), full thickness (n = 34, 13.9%), and split earlobe defects (n = 5, 2%). Most of the patients (n = 110, 54.7%) were managed by emergency medicine providers. Plastic and reconstructive surgery (n = 34, 16.9%) and otorhinolaryngology (n = 32, 15.9%) consultations were obtained when the lacerations affected cartilage (P < 0.001). Surgical repair included primary closure in 203 (82.5%), with 179 (88.2%) performed under local/topical anesthesia in the ED. Of patients with cartilage lacerations (n = 61), 48 had cartilage repair. Eight patients had preoperative intravenous antibiotics, while 105 (42.7%) received postoperative prophylactic oral antibiotics. Among those with intermediate and full-thickness injuries (n = 96), 67.7% were discharged on prophylactic oral antibiotics. Only 1 case of surgical site infection occurred in a patient with a superficial laceration.
Pediatric ear lacerations mostly affect boys aged 2-5 years and are usually repaired under local anesthesia in the ED. The incidence of infection is low, and the routine prescription of prophylactic oral antibiotics appears to have a limited impact on the overall incidence of surgical site infection. Further studies are needed to validate these findings.
小儿耳部裂伤的抗生素管理和使用缺乏标准化。本研究旨在全面回顾这些损伤，并评估围手术期使用抗生素对修复后感染发生率的影响。
回顾性分析1998年至2024年在我院急诊科治疗的所有小儿耳部裂伤病例。
共纳入246例患者（177例男孩）。0至6岁的患者受影响最大（n = 117，47.6%），高峰年龄在2至5岁之间（n = 78，31.7%）。大多数裂伤为浅表性（n = 145，58.9%），其次为中度（n = 62，25.2%）、全层（n = 34，13.9%）和耳垂裂伤缺损（n = 5，2%）。大多数患者（n = 110，54.7%）由急诊医学人员处理。当裂伤累及软骨时，会寻求整形和重建外科（n = 34，16.9%）和耳鼻喉科（n = 32，15.9%）会诊（P < 0.001）。手术修复包括203例一期缝合（82.5%），其中179例（88.2%）在急诊科局部/表面麻醉下进行。在软骨裂伤患者（n = 61）中，48例进行了软骨修复。8例患者术前静脉使用抗生素，105例（42.7%）术后接受预防性口服抗生素治疗。在中度和全层损伤患者（n = 96）中，67.7%出院时接受预防性口服抗生素治疗。仅1例浅表裂伤患者发生手术部位感染。
小儿耳部裂伤大多影响2至5岁的男孩，通常在急诊科局部麻醉下进行修复。感染发生率较低，预防性口服抗生素的常规处方似乎对手术部位感染的总体发生率影响有限。需要进一步研究来验证这些发现。
