Secondary island composite flap: an experimental study in ear reconstruction

An experimental study is presented which demonstrates that a large composite graft of cartilage and skin can survive with an overlying skin flap. The grafts were transferred without loss of configuration when the composite tissue was placed on a bed of vascular tissue. The presence of a skin flap over the graft appears to assist in providing an environment conducive to survival while neovascularization is occurring. This is the first stage in developing a technique of ear reconstruction in which the overlying skin is not used and the cartilage will retain its shape with subsequent transfer.