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Donor site reconstitution for ear reconstruction.

Adel Fattah1, Neil J Sebire, Neil W Bulstrode

  • 1Department of Plastic Surgery, Great Ormond St. Hospital for Children NHS Trust, Great Ormond St, London WC1N 3JH, UK. adelfattah@doctors.org.uk

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|August 25, 2009
PubMed
Summary

Reconstructing the rib donor site after ear reconstruction improves chest contour and reduces deformity. This method offers objective benefits for patients undergoing autologous cartilage grafting.

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Area of Science:

  • Plastic Surgery
  • Regenerative Medicine
  • Biomaterials

Background:

  • Autologous ear reconstruction utilizes costal cartilage frameworks requiring soft tissue coverage.
  • Donor site morbidity from cartilage harvesting is often undocumented.
  • This study evaluates a novel reconstruction method for the costal cartilage donor site.

Purpose of the Study:

  • To describe a method for reconstructing the costal cartilage donor site.
  • To analyze the outcomes of ear reconstruction with and without donor site reconstitution.
  • To assess patient satisfaction and objective deformity at the donor site.

Main Methods:

  • Donor site reconstitution involved wrapping morcelized cartilage in vicryl mesh.
  • Twenty-one patients received reconstitution; nine did not.

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  • Outcomes were assessed using a modified Vancouver scar scale and SF36 questionnaire, with histological analysis of reconstituted sites.

    • Main Results:

    • Patients without reconstitution often had palpable defects and visible chest deformity.
    • Reconstituted rib sites showed no significant chest wall deformity.
    • Histological analysis confirmed neo-rib formation with hyaline cartilage and fibrous tissue; reconstituted group reported higher satisfaction.

    Conclusions:

    • Rib reconstitution objectively improves costal margin contour and reduces chest wall deformity.
    • While subjective benefit differences were minimal, objective outcomes favor reconstitution.
    • The technique provides a viable option for mitigating donor site deformities in autologous reconstruction.