Clinical Application Of Auricular Reconstruction With Repeated Rapid Skin Expansion

Objective :Auricular reconstruction is difficult to conquer in Plastic surgery. There are many kinds of clinical surgical method to reconstruction the vivid ears, but the complications were difficult to avoided. Using the kidney-shaped expander to expanded the skin behind the ear, and this method is the mainstream of auricle reconstruction. The objective of this study wan discuss the comparing of two expansion methods( repeated rapid expansion method and convenient expansion method) of Auricular reconstruction about their surgical operation method and clinical effect of immediate and long-term.Method:From July 2010 to May 2014, the patients 56 cases(58 ears) were randomly divided into observation group(improved expansion method) 30 cases, on the third day after operation began to expanding, when large pale skin tension to stop expansion, placed 3 min and pulled out most of the water, maintain 3 min, and then expanded to the above situation. Repeated three times like this, 5ml each expansion, expanding once a day to maintain 4-6weeks after the 70 ml. The control group(conventional expansion method) 26 cases, on the third day after operation began to expanding, 5ml each expansion, expanding twice a week to maintain 4weeks after the 70 ml. All of the patients expanded the mastoid region flap behind ear. The second procedure both those two groups use the same method for ear reconstruction. The clinical effect was observed both methods.Results:Compare two groups of patients the incidence of surgical complications, Pain count when expanded the flap behind ears and the therapy time, the results shows: ①The main complications of ear reconstruction were cartilage exposure, narrow cranioauricular angle, both sides of the pinna asymmetry. Observation group achieved good effect in the second procedure. Complication of cartilage exposure, narrow cranioauricular angle, both sides of the pinna asymmetry in observation group had significant difference with control group. P<0.05 ②Pain is a common complication of expansion surgical, especially in the late of conventional expansion, patients often feel pain obviously. Pain count when expand the flap behind ears in observation group had significant difference with control group. P<0.01. ③ Compare with the control group, Observation group has more short time of therapy, About 60.67 days, and the control group have about 90.89 days. ④ Comparison of the incidence of the one-stage operation, two groups had no significant difference. P>0.05.Conclusion Repeated rapid expansion is repeated excess-maintaining method. It expanded the skin flap in advance, give full play to the flap of biological function of proliferation. Repeated ischemia-reperfusion promoting cytokine released, as EGF, PCNA and so on, they can promote vascular endothelial cell regeneration, stimulate skin cell proliferation, increase the effective expansion skin. In addition, the duration time was short, the coated was thin, it reduce the flap contraction,which helps cutting cartilage exposure, narrow cranioauricular angle, both sides of the pinna asymmetry rates, it can reduce the pain of patients as well as shorten Disease Course,it can be a better Skin expansion method in auricle reconstruction.