Vacuum-Assisted Closure Device as a Suction Tool in First Stage Autologous Auricular Reconstruction

Autologous auricular reconstruction typically involves the fabrication and insertion of a costal cartilage framework. Achieving a natural contour requires the skin envelope and cartilage framework to remain in close touch. Traditional suction drains might not be able to sustain a constant negative pressure, leading to suboptimal outcomes. This study evaluates the novel use of a vacuum-assisted closure (VAC) device as a suction tool in the first stage autologous auricular reconstruction.

Twenty patients; with unilateral microtia underwent autologous ear reconstruction using costal cartilage graft were selected, 10 patients used a syringe as a traditional method for suction while 10 patients underwent reconstruction with the incorporation of a VAC device to provide an uniform negative pressure and promote adherence of the skin flap to the underlying structure. Outcome measures included skin flap viability, contour definition, complication rates, and patient satisfaction.

Patients reported high satisfaction rates with early aesthetic outcomes higher for the VAC group (22 ± 1.49) than syringe suction (18 ± 1.17) (P < 0.001). Also, 9 out of 10 patients (90%) in VAC group didn't record any complication while 30% of Syringe patients had complications like hematoma, skin necrosis and exposed cartilage. Use of the VAC device resulted in improved skin adherence and enhanced definition of auricular subunits.

The VAC device is a safe and effective tool for optimizing surgical outcomes in the first stage of autologous auricular reconstruction. Its application promotes consistent contouring, reduces complications, and enhances patient satisfaction. Further studies are warranted to validate long-term benefits.