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

Area of Science:

• Dermatologic surgery
• Plastic surgery
• Otolaryngology

Background:

• Helical rim reconstruction presents challenges due to cartilage rigidity and limited tissue laxity.
• Current methods for defects larger than 1.5 cm² often involve flaps, increasing complication risks.
• Limited data exists on the efficacy of simple linear closure combined with cartilage sculpting for helical rim defects.

Purpose of the Study:

• To assess the cosmetic outcomes and complication rates of linear closure with cartilage sculpting for helical rim defects measuring up to 2.5 cm².

Main Methods:

• Fifteen patients with helical rim defects underwent Mohs micrographic surgery followed by cartilage trimming and primary complex closure.
• Complications were evaluated post-operatively.
• Scar assessments were performed by blinded dermatologic surgeons using the SCAR scale, and patient satisfaction was measured with the Patient Observer Scar Assessment Scale (POSAS) at a minimum of 3 months post-surgery.

Main Results:

• No infections or hematomas were observed; one instance of wound dehiscence (6.7%) occurred.
• The majority of scars showed desirable characteristics: 86.7% had minimal spread, 96.7% lacked significant erythema, and 96.7% had no track marks.
• Overall cosmetic appearance was rated as "desirable" in 90.0% of cases, with a mean POSAS score of 8.3 and high patient satisfaction.

Conclusions:

• Linear closure combined with limited cartilage trimming provides excellent cosmetic results and a low complication profile for helical rim defects up to 2.5 cm².
• This technique represents a safe and effective reconstructive option for specific auricular defects.