N.J. Mortimer, E. Tan , P.J.M. Salmon
Numerous reconstructive options exist for surgical wounds
of the posterior pinna, These include second intent healing,
skin grafting and ﬂ ap repairs. All have their advantages and
limitations. Second intent is prolonged, especially for larger
defects, and necessitates daily wound care. Flap repairs (eg.
O-T, single lobed and bilobed transposition ﬂ aps) usually
require extensive undermining and may cause pinning
back of the ear and/or distortion of the ﬂ exible cartilaginous
framework of the pinna. Full or split thickness grafts
are excellent reconstructive options for defects limited to
the posterior surface of the pinna but generally rely on
intact perichondrium for survival and do not address the
loss of soft tissue in deeper defects.
The helical rim advancement ﬂ ap (HRAF) conventionally
has been used as a workhorse ﬂ ap for the reconstruction of
surgical defects of the helical rim of the pinna, however its
utility for defects of the posterior pinna not involving the
helical rim has not previously been described. We describe
our experience with the above reconstructive method
which serves as a useful repair option for selected defects
of the posterior pinna.