The utility of full-thickness skin grafts (FTSGs) for auricular reconstruction

Abstract

Full-thickness skin grafts (FTSGs) are a common repair option on the external ear, but there are few large case series examining graft sublocations, dimensions, and outcomes. We sought to report our experience with FTSGs for repair of postsurgical defects of the external ear. We conducted a retrospective review of all FTSGs on the ear performed by 2 surgeons (J. C., 2000-2014; B. C. L., 2007-2014) after clearance by Mohs micrographic surgery at a single institution. A total of 1519 FTSGs on the ear were performed between June 2000 and March 2014. The most common sublocations were the superior helix (38.8%), the crura of the antihelix or scapha (18.9%), and the back of ear/back ofhelix (15.4%). The overall complication rate was 1.6%, and the most common complication was graft failure (1.2%). Data were collected retrospectively from a single institution. Follow-up beyond 3months was limited. A standardized assessment tool for aesthetic outcomes was not performed. By taking advantage of predictable "pincushioning" and combining with local flaps or cartilage grafts, FTSGs can provide more volumetric replacement than previously described. They reliably preserve the height and complex topography of the ear with a low complication rate.