Sculpo Repair: Linear Closure With Cartilage Sculpting for Helical Rim Defects ≤ 2.5 cm²

Helical-rim reconstruction is limited by rigid cartilage and minimal laxity. Linear repair may be used for defects <1.5 cm², whereas larger wounds require flaps that increase complication risk; data on simple linear closure with cartilage sculpting are lacking.

To evaluate cosmetic outcomes and complications of linear closure with cartilage sculpting for helical rim defects ≤2.5 cm².

Fifteen patients with helical rim defects underwent Mohs micrographic surgery followed by cartilage trimming and primary complex closure. Complications were assessed at suture removal (7-10 days). At ≥ 3 months, scars were evaluated by 2 blinded dermatologic surgeons using the SCAR scale, and patients completed the Patient Observer Scar Assessment Scale (POSAS).

No infections or hematomas occurred, and one dehiscence (6.7%) was reported. Among 30 SCAR ratings, scar spread was none/pencil-thin in 26 (86.7%), erythema absent/light-pink in 29 (96.7%), track marks absent in 29 (96.7%), and overall appearance "desirable" in 27 (90.0%). The mean POSAS score was 8.3 ± 3.6/60; the mean overall satisfaction was 1.1 ± 0.3/10 (lower = better).

Linear closure with limited cartilage trimming yields excellent cosmesis and minimal complications for helical rim defects up to 2.5 cm².