Treatment and outcome of postoperative infection of rib cartilage framework in ear reconstruction
10.3760/cma.j.issn.1009-4598.2017.03.003
- VernacularTitle: 肋软骨支架耳廓再造术后感染的治疗和预后分析
- Author:
Hengyun SUN
1
;
Yanyong ZHAO
;
Haiyue JIANG
;
Qinghua YANG
;
Leren HE
;
Bo PAN
;
Lin LIN
;
Jingjian HAN
;
Ying LIU
Author Information
1. Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China
- Publication Type:Clinical Trail
- Keywords:
Otoplasty;
Infection;
Cartilage;
Postoperative complications;
Prognosis
- From:
Chinese Journal of Plastic Surgery
2017;33(3):171-174
- CountryChina
- Language:Chinese
-
Abstract:
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.
