[Pressure ulcer following compression otoplasty garment: A rare but severe case report]

Otoplasty is a common procedure in plastic surgery. A compression garment is frequently recommended by surgeons after the procedure; however, it is not free from risk of serious complications. We report the case of a pressure ulcer following otoplasty, associated with the use of an inappropriate compression garment.

A 7-year old girl was evaluated for correction of prominent ears. The procedure was uneventful. On the day after surgery, the compression garment that had been prescribed during the preoperative consultation could not be checked. She was discharged home with a custom-made compressive dressing and instructed to replace it the following day with the recommended compression headband. At the postoperative follow-up visit on day 10, she presented with a stage-4 pressure ulcer sore of the left external ear, located over the antihelix. The compression garment in place did not correspond to the one initially recommended. The patient was readmitted, and the compression was immediately removed. Daily local wound care was initiated, including debridement of fibrin under nitrous oxide analgesia, application of petrolatum-based dressings, and prophylactic antibiotic therapy. The clinical course was favorable, allowing discharge after a few days. Close outpatient follow-up was organized. Three months later, she exhibited no aesthetic sequelae.

Pressure ulcer sore following otoplasty is a rare complication and is scarcely mentioned in the literature. Its potential severity should not be overlooked. Although postoperative compression is widely used, its benefit after otoplasty-and more broadly after other procedures in plastic surgery-has not been demonstrated in the literature. Its prescription must therefore be approached with caution, with careful selection of the device, patient education and close monitoring.