Document Detail


Donor site reconstitution for ear reconstruction.
MedLine Citation:
PMID:  19699699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Current techniques of autologous ear reconstruction involve the soft tissue coverage of a carved costal cartilage framework. However, assessment of the morbidity associated with this donor site has been little documented. This study describes a method to reconstruct the defect and analyses the outcomes with or without donor site reconstitution. METHODS: The donor site was reconstituted by wrapping morcelised cartilage in a vicryl mesh. Twenty-one patients with reconstitution and nine without were recruited to the study. Scar quality and length, dimensions of donor defect and visible deformity were recorded according to a modified Vancouver scar scale. Patients were also assessed by the SF36 questionnaire, a well-validated health survey. In a subset of our study group, we assessed the fate of the donor site reconstitution by direct visualisation in situ and histological analysis. RESULTS: Fifteen donor sites of patients without donor site reconstitution were compared to 23 reconstructed donor sites. In those without, all had a palpable defect with nearly half exhibiting visible chest deformity. In contrast, those that had rib reconstitution did not demonstrate significant chest wall deformity. Intraoperative examination demonstrated formation of a neo-rib, histologically proven to comprise hyaline cartilage admixed with fibrous tissue. Analysis of SF36 results showed a higher satisfaction in the reconstituted group, but in both groups, the donor site was of little overall morbidity. CONCLUSIONS: Although there is little difference between the groups in terms of subjectively perceived benefit, rib reconstitution is objectively associated with better costal margin contour and less chest wall deformity.
Authors:
Adel Fattah; Neil J Sebire; Neil W Bulstrode
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Publication Detail:
Type:  Journal Article     Date:  2009-08-21
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  63     ISSN:  1878-0539     ISO Abbreviation:  J Plast Reconstr Aesthet Surg     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1459-65     Citation Subset:  IM    
Copyright Information:
Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Plastic Surgery, Great Ormond St. Hospital for Children NHS Trust, Great Ormond St, London WC1N 3JH, UK. adelfattah@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cartilage / transplantation*
Child
Cicatrix / prevention & control
Ear, External / surgery*
Female
Humans
Male
Otologic Surgical Procedures / methods*
Prospective Studies
Quality of Life
Questionnaires
Reconstructive Surgical Procedures / methods*
Ribs / transplantation*
Surgical Mesh
Transplantation, Autologous
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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