EAR REPLANTATION WITHOUT MICROSURGERY

Reconstitution of the amputated ear remains a challenge to the plastic surgeon. Reattachment as a composite graft of the total or subtotal a mputated ear is unreliable. Microsurgical replantation can be performe d in a minority of cases; however, difficult with adequate venous drai nage complicates the technical complexity of these cases. To enhance s urvival of a reattached ear segment, Mladick et al. advocated use of t he retroauricular pocket principle. This technique involves deepitheli alization of the amputated part, followed by anatomic reattachment to the amputation stump and then burial in a retroauricular pocket. This simple technique increases the surface area of the avulsed segment in contact with surrounding nutrients, maximizing the probability of ''ta ke.'' The relationship between the dermis and cartilage is preserved, thus minimizing the deformity from cartilage warping. The undisturbed dermis on the involved segment can reepithelialize spontaneously, nega ting the need for a skin graft. We have used this technique successful ly in five of six patients.