Analysis of the microcirculation after soft tissue reconstruction of the burned outer ear in patients with severe burn injuries

Publication date: Available online 2 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Fabian Medved, Raluca Medesan, Jens Martin Rothenberger, Hans-Eberhard Schaller, Thomas Schoeller, Theodora Manoli, Lennart Weitgasser, Aline Naumann, Laurenz Weitgasser
Reconstruction of soft tissue defects of the burned ear remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control-study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the burned outer ear in six severely burned Caucasian patients (three men, three women; mean age, 46 years [range, 22–70]) were compared to those in healthy tissue of the outer ear by using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the burned outer ear in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the burned auricle.



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