title: Design and preliminary testing of a novel skin expander for total ear reconstruction in a rabbit model.
abstract: BACKGROUND
  Ear reconstruction is one of the most complicated and challenging techniques in plastic surgery because of the histologic and anatomic properties of the ear. Success depends on fitting the auriform cartilage scaffold into the overlying skin, but current approaches can just give results that are not lifelike and can lead to complications.
  
  
  METHODS
  A novel double-capsule, double-valve plastic ear expander was designed and implanted subcutaneously on either side of the dorsum of six New Zealand white rabbits (two expanders per rabbit). The outer capsule was expanded by injecting approximately 120 mL of physiological saline, then withdrawing the liquid on two occasions. Next, the ear-shaped inner capsule was filled with high-hardness plaster, and the external capsule was emptied such that the expanded skin flap and external capsule responded to the negative pressure and closed over the ear-shaped inner capsule. As a result, the skin flap adopted an ear shape. The ear expander was left in place for 4 wk, removed with the help of a mini-incision, and stripped of its fibrous capsule. To simulate human ear reconstruction, the expander was replaced with an auriform silicone prosthesis, and the effects of auricular reconstruction were observed dynamically.
  
  
  RESULTS
  All 12 skin flaps maintained abundant blood supply, created a clear outline of the ear framework, and produced a lifelike result. No complications were observed during the 4-wk observation period.
  
  
  CONCLUSIONS
  The expanded skin flaps described here can mold to the desired contours and appear lifelike, as well as maintain abundant blood supply. This may provide a simpler approach to total ear reconstruction that reduces risk of complications.
authors: Department of Plastic Surgery of the Third Xiangya Hospital, Central South University, Changsha, China; Department of Burn and Plastic Surgery of the First Hospital of Hunan University of Chinese Medicine, Changsha, China.
authors: Wu
authors: W
authors: Xiong
authors: Xiangya School of Medicine, Central South University, Changsha, China.
authors: Yu
authors: Y
authors: Yan
authors: Department of Plastic Surgery of the Third Xiangya Hospital, Central South University, Changsha, China.
authors: Feng
authors: F
authors: Hu
authors: Department of Plastic Surgery of the Third Xiangya Hospital, Central South University, Changsha, China.
authors: Can
authors: C
authors: Liu
authors: Department of Plastic Surgery of the Third Xiangya Hospital, Central South University, Changsha, China.
authors: Shaohua
authors: S
authors: Wang
authors: Department of Plastic Surgery of the Third Xiangya Hospital, Central South University, Changsha, China.
authors: Jia
authors: J
authors: Chen
authors: Xiangya School of Medicine, Central South University, Changsha, China.
authors: Xueqi
authors: X
authors: Wang
authors: Department of Plastic Surgery of the Third Xiangya Hospital, Central South University, Changsha, China. Electronic address: doctorzhoujianda@163.com.
authors: Jianda
authors: J
authors: Zhou
mesh_terms: D000818:Animals; D004431:Ear, External / Q000601:surgery*; D005260:Female; D017063:Outcome Assessment, Health Care; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000295:instrumentation / Q000379:methods; D015625:Tissue Expansion Devices
keywords: Animal model; Auricular reconstruction; Microtia; Skin expander; Skin flap