AN INTERLOCKING AURICULAR COMPOSITE GRAFT

BACKGROUND. Full-thickness defects of the nasal alar rim are relativel y common following Mohs micrographic surgery for the treatment of long -standing or recurrent skin tumors. Composite grafts provide an excell ent cosmetic and functional alternative for the repair of such defects . OBJECTIVE. A useful technique of auricular composite graft placement for reconstruction of full-thickness nasal alar rim defects is descri bed. METHODS. The cartilaginous portion of the graft is extended beyon d the borders of the soft tissue defect so that two cartilaginous pegs frame the lateral aspects of the graft. These pegs are then inserted into pockets prepared within the alar tissue of both sides of the defe ct, such that the graft interlocks with its recipient bed. A series of diagrams as well as a set of photographs from a representative case a re provided, along with accompanying commentary, so as to enable the s urgeon to incorporate this technique easily into his/her practice. CON CLUSION. The interlocking auricular composite graft technique permits increased graft stability, with decreased sheaving forces of the graft over its recipient bed, and a larger surface area for revascularizati on, resulting in an increased probability of graft survival. This tech nique provides an elegant single stage alternative to current reconstr uctive techniques for full-thickness nasal alar rim defects measuring less than 1.5 cm in diameter.