Ultra-delicate split-thickness skin graft in continuity with full-thickness skin flap combined with Z-plasty for correction of cryptotia / 中华整形外科杂志

Objective@#To explore the curative effect of ultra-delicate split-thickness skin graft in continuity with full-thickness skin flap combined with Z-plasty for correction of cryptotia.@*Methods@#Four cases (six ears) were corrected by ultra-delicate split-thickness skin graft in continuity with full-thickness skin flap combined with Z-plasty method from 2016 to 2017. Following ear release, the flap is rotated into the defect and donor site covered by a razor-thin graft raised in continuity with the flap, the posterior flap was advanced and sutured with Z-plasty.@*Results@#All corrected auricles four cases (six ears) were followed up from 3 months to 1 year and abtained satisfactory and stable appearance.@*Conclusions@#The shape of auricle is natural and satisfactory after operation. The method is simple and no skin grafting is needed. The adhesion of the hidden muscles and cartilages were sufficiently released.

Treatment and outcome of postoperative infection of rib cartilage framework in ear reconstruction / 中华整形外科杂志

Objective@#To investigate treatment and outcome of rib cartilage framework in ear reconstruction.@*Methods@#12 cases of rib cartilage framework infection in ear reconstruction were retrospectively analysed in the latest four years. Lab examination results showed that staphylococcus aureus were found in 5 cases, coagulase negative staphylococcus in 3 cases, Klebsiella pneumonia in 2 cases, aeromonas hydrophila in 1 case and no bacteria were found in 1 case with regular culture. Debridement, systemic antibiotic therapy, saline irrigations and unobstructed drainage were utilized to treat the infection.@*Results@#The average duration of dressing change was 35 days in 12 cases (12-67 days), of which six cases were cured leaving no obvious or mild change of cartilage framework. Cartilage framework was totally damaged by infection in one case, so the framework had to be removed and debridement was then carried out to control infection. Secondary repair should be taken at least 6 months later. In the rest 5 cases, frameworks were taken out in the early stage of infection. The infected portion of the cartilage was removed and the healthy part was buried subcutaneously in the chest. The expanded postauricular flap and fascia were smoothened. Secondary repair should be performed after 6 months.@*Conclusions@#Effective debridement, irrigations and drainage can be used to control infection of cartilage framework and maintain normal contour and structure of reconstructed auricle. With regards to severe infection, framework should be removed as early as possible and infected portion of cartilage should be cleared out, while healthy part could be used for secondary reconstruction of auricular contour after complete control of infection.

Reconstruction of large vermilion defects with buccinator myomucosal flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate a novel method for the reconstruction of large vermilion defects.</p><p><b>METHODS</b>Based on the size and shape of the defects, a buccinator myomucosal flap pedicled with the junction of buccinator and orbicularis oris in the oral commisure was designed and rotated to reconstruct the large vermilion defects. The upper bound of the flap is at least 1 cm away from the stensen's duct. The width is about 2.5-3.0 cm, and the length is as far as to arrive the raphe pterygomancibularis. The donate site is directly closed primarily. There is no need for secondary pedicle division.</p><p><b>RESULTS</b>From July 2003 to April 2013, 14 cases with large vermilion defects was reconstructed with this method. No flap necrosis occurred with primary healing. 5 cases were followed up with an average follow up period of 1 year (0.5-3 years). The apprearance and function of the reconstructed vermilion were satisfactory without any apparent donor site defect. The patients were satisfied with both the functional and cosmetic results.</p><p><b>CONCLUSION</b>The buccinator myomucosal flap is a simple and ideal method for reconstruction of large vermilion defects, especially for the defects closed to the commisure.</p>

Implication of technique of "two-flap" in ear reconstruction / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the technique of "two-flap" in ear reconstruction.@*METHOD@#Quantitative tissue expansions were used in the mastoid area in the first stage. After the final injection, there was 1 month of sustaining time. Expanded skin flap and unexpanded fascia flap were designed in the second stage, so the "two-flap" technique was used in the ear reconstruction. From January 2004 to December 2008, 1427 patients of microtia were treated using "two-flap" technique.@*RESULT@#The expanded skin flap could show the fine structures of the reconstructed ears. The reconstructed ears had vivid cranioauricular angle after using the unexpanded fascia flap.@*CONCLUSION@#"Two-flap" method was easily manipulated and the complications were rare. The reconstructed ears had lucid and three-dimensional contour.

"Implication of technique of ""two-flap"" in ear reconstruction" / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the technique of two-flap in ear reconstruction.Method:Quantitative tissue expansions were used in the mastoid area in the first stage.After the final injection,there was 1 month of sustaining time.Expanded skin flap and unexpanded fascia flap were designed in the second stage,so thetwo-flaptechnique was used in the ear reconstruction.From January 2004 to December 2008,1 427 patients of microtia were treated using two-flap technque.Result:The expanded skin flap could show the fine structures of the reconstructed ears.The reconstructed ears had vivid cranioauricular angle after using the unexpanded fascia flap.Conclusion: Two-flap method was easily manipulated and the complications were rare.The reconstructed ears had lucid and three-dimensional contour.

Reconstruction of the external ear utilizing expanded scarred skin flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of ear reconstruction using local expanded scarred skin flap.</p><p><b>METHOD</b>We used local postauricular expanded scar skin flaps to reconstruct external ear in 24 patients.</p><p><b>RESULTS</b>Of these cases, 22 flaps survived completely. In 2 patients, the cartilage framework exposed over the upper pole of helix region because of undue tension in suturing the tissue edges. One year's follow-up revealed satisfactory results.</p><p><b>CONCLUSION</b>Using the expanded scarred skin flap for ear reconstruction is practical and effective, when there's no normal skin available in the local area.</p>

Surgical depilation in low hairline aurical reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>Low hairline is one of the most troublesome problem in auricle reconstruction. There was no satisfactory way to manage the problem. This article discuss surgical depilation to deal with this problem and reconstructed auricle.</p><p><b>METHODS</b>According to the degree of the low hairline, Postaurical scalp was expanded and part of the lower follicles within the dermal were removed, or postaurical scalp that part of lower follicles and dermal had been removed was expanded and covered skeleton of ear with this expanded skin to reconstructed auricle.</p><p><b>RESULTS</b>Auricles were reconstructed with this method in 152 lowhairline microtial cases, the result was very satisfactory.</p><p><b>CONCLUSION</b>This procedure is an effective way to deal with low hairline in reconstructing auricle.</p>