Reconstruction of post-traumatic full-thickness defects of the upper one-third of the auricle.

BACKGROUND: Reconstruction of partial ear defects represents a difficult challenge to the plastic surgeon due to the delicate and intricate architecture of the chondrocutaneous sandwich of the external ear. METHODS: Fourteen patients with acute or previous traumatic subtotal loss of the upper one-third of the auricle were treated with autologous contralateral conchal cartilage graft and superficial temporoparietal fascia flaps. RESULTS: The symmetry of the reconstructed ears was satisfactory and the cosmetic appearance was acceptable for 13 patients. Minor hematoma at the conchal cartilage graft donor site occurred in one (7.1%) patient and marginal loss of temporoparietal flap in another (7.1%). Revision surgery was required for widening of the scar and obscuring of the upper pole contour in one (7.1%) patient. No additional complications were encountered. CONCLUSION: The authors recommend using this combined technique for reconstruction of full-thickness auricular defects.

HISTORIQUE: La reconstruction d'anomalies partielles de l'oreille pose un défi particulier au chirurgien plasticien en raison de l'architecture délicate et complexe du bourgeonnement chondrocutané de l'oreille externe. MÉTHODOLOGIE: Quatorze patients ayant subi une perte traumatique subtotale aiguë ou antérieure du tiers supérieur de l'oreille se sont fait traiter par une greffe du cartilage de la conque controlatérale autologue et des lambeaux superficiels de fascia temporopariétal. RÉSULTATS: Treize patients ont trouvé la symétrie de l'oreille reconstruite satisfaisante et leur aspect esthétique acceptable. Un patient (7,1 %) a présenté un hématome mineur au foyer de la greffe de cartilage de la conque et un autre (7,1 %), une perte marginale du lambeau temporopariétal. Un patient (7,1 %) a dû subir une opération de reprise pour élargir la cicatrice et occulter le contour du pôle supérieur. Aucune autre complication ne s'est produite. CONCLUSION: Les auteurs recommandent cette technique combinée pour la reconstruction des anomalies de toute l'épaisseur de l'oreille.

Fibrin sealant and lipoabdominoplasty in obese grade 1 and 2 patients.

BACKGROUND: Ever since lipoabdominoplasty was first developed to achieve better aesthetic outcomes and less morbidity, the rate of seroma formation, especially in obese patients, has disturbed plastic surgeons. The aim of this study was to evaluate the effect of fibrin sealant in the prevention of seroma formation after lipoabdominoplasty in obese patients. METHODS: Sixty patients with a body mass index (BMI) between 30 and 39.9 were assigned randomly to 1 of 2 groups (30 patients each). Group A underwent lipoabdominoplasty with fibrin glue, while group B underwent traditional lipoabdominoplasty; both had closed suction drainage applied to the abdomen. The patients' demographics and postoperative complications were recorded. Seroma was detected using abdominal ultrasound examinations at two postoperative periods: between postoperative days 10 and 12 and, between postoperative days 18 and 21. RESULTS: The age range was 31 to 55 years (38.5±9.5 years) in group A and 25 to 58 years (37.8±9.1 years) in group B, while the mean BMI was 31.4 to 39.9 kg/m(2) (32.6 kg/m(2)) in group A and 32.7 to 37.4 kg/m(2) (31.5 kg/m(2)) in group B. In group A, the patients had a complication rate of 10% in group A versus 43% in group B (P<0.05). The incidence of seroma formation was 3% in the fibrin glue group but 37% in the lipoabdominoplasty-alone group (P<0.05). CONCLUSIONS: Lipoabdominoplasty with the use of autologous fibrin sealant is a very effective method that significantly reduces the rate of postoperative seroma.