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The postauricular fasciocutaneous flap with an adipofascial extension: A case report

View Article: PubMed Central - PubMed

ABSTRACT

The postauricular flap has never been used with an adipofascial extension.

We present a case with an ear defect covered with this flap.

The indications and blood supply of the flap are discussed.

The indications and blood supply of the flap are discussed.

No MeSH data available.


The surgical technique.a) The relatively wide anterior ear defect and the plexus of vessels in the postauricular area.b) The 2 components of the flap (the fasciocutaneous and adipofascial parts) are in-continuity.c) The flap is transposed to cover the defect. The adipofascial component will be covered with a skin graft. The pedicle will be divided at 3 weeks.
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fig0005: The surgical technique.a) The relatively wide anterior ear defect and the plexus of vessels in the postauricular area.b) The 2 components of the flap (the fasciocutaneous and adipofascial parts) are in-continuity.c) The flap is transposed to cover the defect. The adipofascial component will be covered with a skin graft. The pedicle will be divided at 3 weeks.

Mentions: A 5-year old boy was involved in a car accident resulting in an exposed cartilage of the upper part of right ear. Coverage was planned using a postauricular flap. The defect was wide and it was thought that designing the flap as partly fasciocutaneous and partly as adipofascial flap would allow easier primary closure of the donor site. A fasciocutaneous flap was designed from the mastoid area with an adipofascial extension from the posterior surface of the ear. The total width of the fasciocutaneous and adipofascial components were designed slightly wider than the defect. The flap was raised as a superiorly based flap. Skin incisions were made inferiorly; including the mastoid fascia; to ensure the inclusion of the retroauricular neurovascular bundle. The skin incision towards the retroauricular sulcus was made only to the subdermal layer and the skin was elevated from the underlying adipofascial tissue for the appropriate extra width required to cover the defect. This adipofascial tissue was included as an extension to (i.e. in-continuity with) the fasciocutaneous flap. The flap was then brought to the anterior surface the ear for coverage of the defect. The adipofascial part covered the excised inferior crus/antihelix cartilages. Following suturing of the flap to the edges of the defect, the adipofascial part was covered with a split skin graft harvested from the scalp. The postauricular donor site was closed primarily. The flap pedicle was divided at 3 weeks. There were no postoperative complications and the parents were satisfied with the result. The surgical technique is demonstrated in Fig. 1 and the clinical pictures in Fig. 2.


The postauricular fasciocutaneous flap with an adipofascial extension: A case report
The surgical technique.a) The relatively wide anterior ear defect and the plexus of vessels in the postauricular area.b) The 2 components of the flap (the fasciocutaneous and adipofascial parts) are in-continuity.c) The flap is transposed to cover the defect. The adipofascial component will be covered with a skin graft. The pedicle will be divided at 3 weeks.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120265&req=5

fig0005: The surgical technique.a) The relatively wide anterior ear defect and the plexus of vessels in the postauricular area.b) The 2 components of the flap (the fasciocutaneous and adipofascial parts) are in-continuity.c) The flap is transposed to cover the defect. The adipofascial component will be covered with a skin graft. The pedicle will be divided at 3 weeks.
Mentions: A 5-year old boy was involved in a car accident resulting in an exposed cartilage of the upper part of right ear. Coverage was planned using a postauricular flap. The defect was wide and it was thought that designing the flap as partly fasciocutaneous and partly as adipofascial flap would allow easier primary closure of the donor site. A fasciocutaneous flap was designed from the mastoid area with an adipofascial extension from the posterior surface of the ear. The total width of the fasciocutaneous and adipofascial components were designed slightly wider than the defect. The flap was raised as a superiorly based flap. Skin incisions were made inferiorly; including the mastoid fascia; to ensure the inclusion of the retroauricular neurovascular bundle. The skin incision towards the retroauricular sulcus was made only to the subdermal layer and the skin was elevated from the underlying adipofascial tissue for the appropriate extra width required to cover the defect. This adipofascial tissue was included as an extension to (i.e. in-continuity with) the fasciocutaneous flap. The flap was then brought to the anterior surface the ear for coverage of the defect. The adipofascial part covered the excised inferior crus/antihelix cartilages. Following suturing of the flap to the edges of the defect, the adipofascial part was covered with a split skin graft harvested from the scalp. The postauricular donor site was closed primarily. The flap pedicle was divided at 3 weeks. There were no postoperative complications and the parents were satisfied with the result. The surgical technique is demonstrated in Fig. 1 and the clinical pictures in Fig. 2.

View Article: PubMed Central - PubMed

ABSTRACT

The postauricular flap has never been used with an adipofascial extension.

We present a case with an ear defect covered with this flap.

The indications and blood supply of the flap are discussed.

The indications and blood supply of the flap are discussed.

No MeSH data available.