Elsevier

Burns

Volume 37, Issue 6, September 2011, Pages e41-e43
Burns

Case report
Revolving-door flap: An alternative for the coverage of acute burn defects of the auricle

https://doi.org/10.1016/j.burns.2011.02.001Get rights and content

Introduction

Ears are special and unique structures that, if damaged, are key difficult to reconstruct. They are often underestimated during the acute treatment of burns. However, thermal injury of relatively moderate proportions can irreparably alter their shape and appearance.

The usual management of auricular burns includes either conservative topical treatment, skin grafting with or without dermal substitutes and ear amputation during the acute phase or delayed reconstructive techniques for the treatment of secuelae.

Herein we present our experience with a revolving-door (RD) flap used to cover a defect concerning the antihelical fold as a single stage procedure for the acute treatment of auricular-conchal burns.

Section snippets

Clinical case

An 85-year-old male suffered a 4% total body surface area superficial and deep second degree burns from flame that resulted when burning stubble. No loss of consciousness occurred and the patient was alert at the scene. Physical exam on admission revealed second-degree burns to his face, neck, right ear, scalp, right hand and forearm. Initial silver sulphadiazine dressings were applied and changed every 24 h. On post-burn-day (PBD) 5 exposure and necrosis of the antihelical skin and cartilage

Discussion

Many reconstructive techniques have been garnered to restore the shape and appearance of the thermally injured ear [1]. The goals for external ear reconstruction are to provide skin of appropriate thickness and texture and an adequate framework for support whilst keeping the reconstruction as simple as possible. The appearance of the reconstructed ear should not be distracting when viewed from a conversational distance and the external auditory canal must have an adequate size for its normal

Conflict of interest

None of the authors has any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work.

Author's contribution

Mireia Ruiz, Oihane García and Izaro Hernán participated in the writing and reviewing of the paper. Jaime Sancho, Jordi Serracanta and Joan Pere Barret contributed on the writing of the final manuscript.

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Cited by (5)

  • The burned ear; possibilities and challenges in framework reconstruction and coverage

    2016, Burns
    Citation Excerpt :

    Chondritis is also a serious complication in the acute phase and identifying the ear that will become infected is difficult as it may occur even after superficial burns [3,4]. Debridement of damaged tissue, infection prevention and salvage of remaining cartilage by flap coverage is therefore essential to limit the loss of ear cartilage [5–7]. After taking the necessary steps to preserve as much cartilage as possible, partial defects can be treated through various methods depending on the area size.

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