Study of removing the Medpor and transplanting an expander at the same operative stage to repair the Medpor exposure after ear reconstruction

Abstract

Objective To explore the clinical effect by using expander implantation immediately to repair the Medpor exposure after ear reconstruction. Methods From May 2013 to February 2017, 5 patients were treated with ear reconstructive surgery by Medpor implantation. The previous methods contained not only the auricular posterior fascia flap but also skin grafting. Exposed parts were the upper part of the helix and the wounds were dry without purulent secretions. Bacterial culture did not show bacterial growth. Surgical procedure was to remove the Medpor implant and implant a 50 ml kidney expander. When the wound was healed, we started to inject normal saline into the expander. About 3 months later the total volume of normal saline in the expanders were 80-100 ml.Then we could begin the second operation. We removed the expander and harvested the right side of the 7th and 8th rib cartilage, which were carved into the ear cartilage framework and transplanted into the expansion area. The drainage tube, negative pressure and cotton pad appropriate pressure bandage were needed. 6 days later we removed drainage tube.10 days later we removed the suture. Results The reconstructed external ear shape in five cases were good. No infection occurred. With 6-20 months of follow-up using telephone and WeChat, no obvious deformation of the shape or cartilage exposure occurred. The five patients did not come back to do the third stage operation for financial considerations. They all left their hometown to work out to reduce economic pressure. Conclusions In the case of ear reconstruction for Medpor prosthesis exposure, if the wounds were not infected, removing the Medpor and transplanting an expander at the same operative stage can achieve a good therapeutic effect. Key words: Soft tissue expansion; Medpor; Reconstruction of auricle; Exposure; Repair