The incidences of chondritis and perichondritis associated with the surgical manipulation of auricular cartilage.
BACKGROUND
The cartilage and soft tissues of the ear are frequently employed as donor sites for tissue used in the repair of defects of the nose and external ear after Mohs surgery. Enthusiasm for using these auricular donor sites is occasionally tempered by surgeons' concerns for the development of Pseudomonal suppurative chondritis, a complication that has been described to follow cartilage manipulation.


OBJECTIVE
To quantify the incidence of postoperative perichondritis and chondritis after Mohs reconstructions involving auricular cartilage manipulations.


METHODS
We retrospectively reviewed 341 Mohs reconstructions that involved cartilage and soft-tissue donor sites located on the ear. Procedures included full-thickness skin grafts (295) harvested from the conchal bowl and flap repairs (46) incorporating cartilage batten grafts from conchal or anthelix donor sites. When the perichondrium was compromised, patients were routinely prescribed perioperative prophylactic antibiotics with Pseudomonal coverage. Postoperative examinations were performed at 1 week and 4 to 12 weeks. Patients not seen in clinic were interviewed by telephone regarding complications.


RESULTS
Complete follow-up information was obtained in 337 of 341 (98.8%) cases. Inflammatory perichondritis was observed in 19 (5.6%) patients. There were no cases of suppurative chondritis.


CONCLUSIONS
The incidence of inflammatory perichondritis is low after Mohs reconstructions involving auricular cartilage manipulation. When prophylactic antibiotics and appropriate operative technique are used, the historic concern for suppurative chondritis associated with these procedures is unwarranted.
Kaplan
Andrew L
AL
Department of Medicine (Dermatology), Duke University Medical Center, Durham, North Carolina 27710, USA.
Cook
Jonathan L
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery; D002357:Cartilage Diseases / Q000209:etiology*; D004425:Ear Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery