Zwemstra Max, Geerse Simon, de Wolf Maarten, Ebbens Fenna, Smits Cas, van Spronsen Erik
Department of Otorhinolaryngology, Otolaryngology-Head and Neck Surgery, Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Eur Arch Otorhinolaryngol. 2025 May 15. doi: 10.1007/s00405-025-09453-2.
To evaluate the aesthetic outcomes of primary closure of auricle lacerations in the emergency department.
In this prospective case study in our tertiary referral center we included all patients with an auricular laceration without complete avulsion. Wound treatment involved thorough cleaning and primary closure. Photos of the auricle were taken at various stages for evaluation. To evaluate the achieved results after 3 months, a success classification system with four classes was developed: (1) full success, no irregularities, (2) partial success, only minor irregularities, (3a) unsuccessful, major irregularities or (3b) unsuccessful, (partial) necrosis.
Most patients demonstrated successful outcomes (60.7% full success and 32.1% partial success), with helical involvement being associated with inferior results. The interobserver percent agreement of the classification system was 88%. The Fleiss' kappa coefficient was 0.570, p < 0.001.
Primary closure of ear lacerations results in a high success rate. We have introduced a revised classification system to qualify the success of treatment of the auricle laceration. Involvement of the helix is correlated with inferior surgical results three months after surgical closure. Trial registration number and date of registration: reference number W21_387 # 21.432, September 9, 2021.
评估急诊科耳廓裂伤一期缝合的美学效果。
在我们的三级转诊中心进行的这项前瞻性病例研究中，纳入了所有耳廓裂伤但未完全撕脱的患者。伤口处理包括彻底清洁和一期缝合。在不同阶段拍摄耳廓照片以进行评估。为了评估3个月后的治疗效果，制定了一个分为四类的成功分类系统：（1）完全成功，无畸形；（2）部分成功，仅有轻微畸形；（3a）不成功，有严重畸形或（3b）不成功，（部分）坏死。
大多数患者治疗效果成功（60.7%完全成功，32.1%部分成功），耳廓螺旋缘受累的患者治疗效果较差。分类系统的观察者间百分比一致性为88%。Fleiss卡方系数为0.570，p < 0.001。
耳廓裂伤一期缝合成功率高。我们引入了一种修订的分类系统来评估耳廓裂伤治疗的成功程度。耳廓螺旋缘受累与手术缝合三个月后的手术效果较差相关。试验注册号和注册日期：参考编号W21_387 # 21.432，2021年9月9日。
