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Case Report Plastic and Aesthetic Research

Primary repair of ear laceration with wedge

resection

Bhupinder Singla, Inderjit Chawla, Prasant Gautam, Anupam Goyal, Jalaj Rathi

Department of General Surgery, Rajindra Hospital, Patiala 147001, Punjab, India.
Address for correspondence: Dr. Bhupinder Singla, Department of General Surgery, Government Medical College, Samana Road,
Patiala 147001, Punjab, India. E-mail: akash22singla@yahoo.com

ABSTRACT
Although major contributions have been made in the field of reconstructive surgery, reconstructive
surgery of the auricle is a daunting prospect even for the most experienced surgeons. Here, we present
a case who presented to us in the emergency surgical ward with a history of an accidental laceration of
right ear. Primary repair of the ear laceration after wedge resection of the avulsed part was done. The
cosmesis achieved by this technique is discussed.
Key words:
Ear laceration, primary repair, wedge resection

INTRODUCTION with epinephrine 1:100,000. A wedge excision of the
damaged part of the ear was done. The wound was then
Ear laceration is one of the common auricular injuries closed in a layered fashion re‑approximating the cartilage
among traumatic injuries. The type of reconstruction with 30 catgut and re‑approximating the epidermis with a
selected for the lacerated ear depends on the size of running top suture of 5–0 prolene [Figure 2]. With regular
the defect and the amount of cosmesis expected by the dressings and antiseptic precautions, wound healed well
procedure. It ranges from the wedge resection and direct with no residual necrosis [Figure 3].
advancement to reconstruction with chondrocutaneous
flaps. This report presents a case of auricular laceration DISCUSSION
in 18‑year‑old boy who was managed by primary repair of
the ear after wedge resection. A good cosmetic result was Lacerations and abrasions are among the most common
achieved. auricular injuries. The golden rule in such cases
after adequate local anesthesia is to balance minimal
CASE REPORT debridement with maximal tissue preservation. [1]
Reconstruction of composite (skin and cartilage) defects of
The 18‑year‑old boy presented in our emergency surgery the ear may be broadly classified into two groups: wedge
department with a history of an accident. On examination, resection and direct advancement, and reconstruction
the boy was conscious with laceration of right ear with chondrocutaneous flaps. Small helical defects (often
involving the skin and cartilage with tissue loss [Figure 1]. up to 2 cm) involving the helix and antihelix can be
The ear was washed thoroughly to remove any foreign repaired with a wedge excision. The apex of the wedge
[2]
body. The patient was taken to the emergency operation may extend into the conchal bowl. Wedge resections
theatre for repair with local anesthesia with 1% lidocaine and helical advancements shorten vertical ear height but
maintain the relative proportions. [3]
Access this article online
For defects larger but < 25% of the auricle, a star excision,
Quick Response Code: or anterior composite Burows triangle excision, can
Website:
www.parjournal.net redistribute tension throughout the ear and avoid cupping.
Various chondrocutaneous reconstruction methods have
DOI: been described for defects up to one‑third of the auricle.
10.4103/2347-9264.149378 Large composite defects require a new structural support
followed by a vascularized skin flap.

38 Plast Aesthet Res || Vol 2 || Issue 1 || Jan 15, 2015