Prevention and treatment of rupture and infection in expanded flaps during auricular reconstruction

To analyze the risk factors of infection and necrosis of expanded postauricular flaps during auricular reconstruction and to provide effective management strategies for complications in expanding postauricular flaps. Data were gathered retrospectively for cases of partial rupture and infection of expanding postauricular flaps from the 58 cases of patients undergoing auricular reconstruction after preliminary tissue expansion. Treatment included the following: (1) auricular reconstruction with autologous costal cartilage framework immediately (28 cases); (2) stretching the expanded postauricular flap and fixing in place after expander removal (15 cases); (3) removal of the expander and reinsertion of a similar expander more than 6 months after the wound had healed (12 cases); and (4) continuing expansion after antibiotic treatment (3 cases). Each method was applied to different types of cases. Most cases obtained a satisfactory contour and profile of the reconstructed auricle. Some individual and risks factors are involved in infection and rupture of expanded postauricular flaps, which can be prevented and minimized. An optimal method can be chosen to treat every case of infection and partial rupture of the expanded postauricular flap.