The proposed adaptation of the vacuum-assisted closure technique has several advantages. The contour of the reconstructed auricle is visualized in theater and maintained over the following days, facilitating coaptation. This eliminates the issue of irregular contour for flap-scaffold apposition. Second, edema is reduced, improving vascular perfusion and lymphatic flow and reducing potential bacterial load.4 These factors act in concert to improve take of the reconstructed auricle complex. Intervention required from ward staff is reduced, as vacuum systems are untouched for 4 to 5 days. As in all systems, disadvantages do exist. The primary disadvantage is increased length of ward stay, as patients must stay in proximity to the central vacuum system. In a private hospital setting, a commercially available mobile vacuum-assisted closure system (V.A.C.; KCI, Inc., San Antonio, Texas) has been tested successfully in similar patients, with the advantage of enhanced patient mobility with monitoring on an outpatient basis. Our suggested modification demonstrates a novel application of the vacuum-assisted closure technique and has been proven safe and simple to apply and provides excellent reconstructive outcomes.
Frank R. Graewe, M.D.
Richard J. Ross, B.Sc.(Hons.)
Tim Perks, M.D.
Chris van der Walt, M.D.
Alexander E. Zuehlke, M.D.
1. Brent B. The correction of microtia with autogenous cartilage grafts: I. The classic deformity. Plast Reconstr Surg
2. Nagata S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg
3. Firmin F. Ear reconstruction in cases of typical microtia: Personal experience based on 352 microtic ear corrections. Scand J Plast Reconstr Surg Hand Surg
4. Morykwas MJ, Simpson J, Punger K, Argenta A, Kremers L, Argenta J. Vacuum-assisted closure: State of basic research and physiologic foundation. Plast Reconstr Surg
. 2006;117 (Suppl):121S–126S.
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