Burows Retroauricular UAdvancement Flap

Middle third defects of the helix (Fig. 10.17) can be reconstructed with a broad, posteriorly based flap that is raised in the postauricular sulcus (Fig. 10.17a) and dissected toward the scalp. After raising the flap, we use a film pattern as a guide to make a supportive

Surgical Extraction Raising Flap Suction

Fig. 10.16 Reconstruction of the upper auricle with an anteriorly based flap (L).

a The flap is cut along the stump in the sulcus and superiorly along the hairline. b The cartilage framework is sutured to the stump. The skin on the back of the auricle is sutured to the lower wound margin in the sulcus. c The flap is sutured to the anterior auricular skin and above the cartilage framework. It is coapted to the framework with bolster sutures and a suction drain (DR).

Bolster Facial Surgery

Fig. 10.17 Small middle third defect repaired with a U-ad-vancement flap.

a The wound edges are freshened, and a cartilage framework (K) is implanted. A postauricular U-flap based on the scalp is raised in front of the sulcus. b This flap is sutured to the anterior skin of the stump and coapted to the framework with bolster sutures. c Three weeks later the flap is divided and inset behind the ear. A split-thickness skin graft (SP) may be used to cover the residual defect.

Fig. 10.16 Reconstruction of the upper auricle with an anteriorly based flap (L).

a The flap is cut along the stump in the sulcus and superiorly along the hairline. b The cartilage framework is sutured to the stump. The skin on the back of the auricle is sutured to the lower wound margin in the sulcus. c The flap is sutured to the anterior auricular skin and above the cartilage framework. It is coapted to the framework with bolster sutures and a suction drain (DR).

Fig. 10.17 Small middle third defect repaired with a U-ad-vancement flap.

a The wound edges are freshened, and a cartilage framework (K) is implanted. A postauricular U-flap based on the scalp is raised in front of the sulcus. b This flap is sutured to the anterior skin of the stump and coapted to the framework with bolster sutures. c Three weeks later the flap is divided and inset behind the ear. A split-thickness skin graft (SP) may be used to cover the residual defect.

framework from conchal or rib cartilage before suturing the flap into place (Fig. 10.17b). In the second stage 3-4 weeks later, the flap is divided and inset (Fig. 10.17c). The residual defect is grafted with thick split skin.

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