A bolster suture technique for ear reconstruction for microtia without skin necrosis

A new bolster suture technique to prevent skin necrosis in microtia ear reconstruction is presented. An outer series of bolsters is placed distant from the ear framework in a zigzag fashion, the temporal skin being gathered on the framework. In this way, the skin flap overlying the framework is relaxed and has sufficient blood flow. Therefore the skin flap can be thinned with little risk of necrosis. Furthermore, the contour of the reconstructed auricle is accentuated because of the thin relaxed overlying skin. Seven ears with microtia were reconstructed using this method. The results were satisfactory, except for one auricle which became slightly congested at the conchal portion due to excessive thinning. There were no haematomas or skin necrosis.