title: Analysis of the microcirculation after soft tissue reconstruction of the outer ear with burns in patients with severe burn injuries.
abstract: Reconstruction of soft tissue defects of the ear with burns remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the outer ear with burns in six severely burned Caucasian patients (three men and three women; mean age, 46 years (range, 22-70)) were compared to those in the healthy tissue of the outer ear using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the outer ear with burns in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the auricle with burns.
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany. Electronic address: Fabian.Medved@gmail.com.
authors.forename: Fabian
authors.initials: F
authors.lastname: Medved
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.
authors.forename: Raluca
authors.initials: R
authors.lastname: Medesan
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.
authors.forename: Jens Martin
authors.initials: JM
authors.lastname: Rothenberger
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
authors.affiliation: Department of Plastic Surgery, Microsurgery and Reconstructive Surgery, Marien Hospital Stuttgart, Böheimstraße 37, 70199, Stuttgart, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schoeller
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.
authors.forename: Theodora
authors.initials: T
authors.lastname: Manoli
authors.affiliation: Department of Plastic Surgery, Microsurgery and Reconstructive Surgery, Marien Hospital Stuttgart, Böheimstraße 37, 70199, Stuttgart, Germany.
authors.forename: Lennart
authors.initials: L
authors.lastname: Weitgasser
authors.affiliation: Institute for Clinical Epidemiology and Applied Biometry, Eberhard Karls University Tuebingen, Silcherstraße 5, 72076, Tübingen, Germany.
authors.forename: Aline
authors.initials: A
authors.lastname: Naumann
authors.affiliation: Department of Plastic Surgery, Microsurgery and Reconstructive Surgery, Marien Hospital Stuttgart, Böheimstraße 37, 70199, Stuttgart, Germany.
authors.forename: Laurenz
authors.initials: L
authors.lastname: Weitgasser
mesh_terms: D000328:Adult; D002056:Burns / Q000175:diagnosis / Q000601:surgery; D016022:Case-Control Studies; D004431:Ear, External / Q000293:injuries / Q000601:surgery; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000209:etiology / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*; D013699:Temporal Arteries / Q000601:surgery*; D015599:Trauma Severity Indices; D016896:Treatment Outcome
keywords: Burn injury; Ear reconstruction; Full skin graft; Microcirculation of the ear; Pedicled flap; Random pattern flap