Managing Refractory Infection and Suicide Risk After Auricular Reconstruction

Multidrug-resistant organism (MDRO) infection following auricular reconstruction is uncommon, but it can severely compromise reconstructive outcomes, especially when associated with an increased risk of suicide.

A 39-year-old man developed a refractory MDRO infection following post-traumatic autologous costal cartilage auricular reconstruction, experiencing severe depressive symptoms with suicidal ideation (peak PHQ-9 score: 25).

Postoperative MDRO infection and major depressive disorder with high suicide risk.

An integrated, safety-centred nursing approach was implemented, including: individualised wound care; multidisciplinary antimicrobial management; multimodal pain control; continuous suicide risk assessment.

After 117 days, the infection was under control, and ∼40% of the reconstructed cartilage had been preserved. Laboratory markers normalised, the PHQ-9 score decreased to 8, and the patient was discharged with no suicide risk.

Integrated nursing care can support surgical salvage by stabilising infection and psychological status, thereby improving safety and outcomes in complex auricular reconstruction.