Guilherme Canho Bittner1, Elisa Mayumi Kubo2, Bruno de Carvalho Fantini3, Felipe Bochnia Cerci4. 1. Dermatology Service, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil; Private Practice, Campo Grande, MS, Brazil. Electronic address: clinicahans@outlook.com. 2. Private Practice, Porto União, PR, Brazil. 3. Dermatology Service, Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil. 4. Dermatology Service, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil; Postgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba, PR, Brazil; Private Practice, Curitiba, PR, Brazil.
Abstract
BACKGROUND: The ear is a region that has a high prevalence of cutaneous carcinomas and several guidelines indicate Mohs micrographic surgery as the first-choice treatment in such cases. Although the technique allows maximum preservation of healthy tissue, many auricular surgical wounds constitute a challenge due to the peculiar local anatomy, with evident curves and reliefs. Auricular reconstruction should prioritize function before aesthetics, but without leaving the latter aside, since postoperative distortions can have a significant psychological impact. OBJECTIVE: To describe the authors' experience in auricular reconstruction after Mohs surgery and to evaluate the most frequently used repair methods. METHODS: Retrospective study of consecutive cases submitted to Mohs surgery and auricular reconstruction, over a period of 3 years. RESULTS: One hundred and one cases were included and the most common repair method was primary closure (n = 35), followed by full-thickness skin graft (n = 30) and flaps (n = 24). In thirty cases, reconstruction methods were associated. Seven patients had complications (partial graft necrosis, postoperative bleeding or infection). STUDY LIMITATIONS: Retrospective design and the absence of long-term follow-up of some cases. CONCLUSIONS: The dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.
BACKGROUND: The ear is a region that has a high prevalence of cutaneous carcinomas and several guidelines indicate Mohs micrographic surgery as the first-choice treatment in such cases. Although the technique allows maximum preservation of healthy tissue, many auricular surgical wounds constitute a challenge due to the peculiar local anatomy, with evident curves and reliefs. Auricular reconstruction should prioritize function before aesthetics, but without leaving the latter aside, since postoperative distortions can have a significant psychological impact. OBJECTIVE: To describe the authors' experience in auricular reconstruction after Mohs surgery and to evaluate the most frequently used repair methods. METHODS: Retrospective study of consecutive cases submitted to Mohs surgery and auricular reconstruction, over a period of 3 years. RESULTS: One hundred and one cases were included and the most common repair method was primary closure (n = 35), followed by full-thickness skin graft (n = 30) and flaps (n = 24). In thirty cases, reconstruction methods were associated. Seven patients had complications (partial graft necrosis, postoperative bleeding or infection). STUDY LIMITATIONS: Retrospective design and the absence of long-term follow-up of some cases. CONCLUSIONS: The dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.