scholarly journals Cartilage Graft Donor Site Morbidity following Rhinoplasty and Nasal Reconstruction

2018 ◽  
Vol 11 (4) ◽  
pp. 278-284 ◽  
Author(s):  
Thuy-Van Tina Ho ◽  
Kevin Sykes ◽  
J.David Kriet ◽  
Clinton Humphrey
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Nasal Reconstruction ◽  
Cartilage Graft ◽  
Nasal Surgery ◽  
Auricular Cartilage ◽  
Donor Site Pain ◽  
Graft Donor ◽  
Ear Cartilage ◽  
Site Pain

Although surgical techniques for rhinoplasty and nasal reconstruction are well established, prospective research on postoperative morbidity remains limited. The aim of this pilot study was to assess costal and auricular cartilage donor site pain and morbidity in patients undergoing rhinoplasty and nasal reconstruction. In this prospective cohort study, we enrolled 55 patients undergoing nasal surgery that required costal or auricular cartilage harvest from February 2015 through May 2016. Each patient was given a symptom-specific patient survey that assessed general pain, nasal pain, graft donor site pain, graft donor site itching, color variation, skin stiffness and thickness, and graft donor site appearance at 1, 4, and 12 weeks after surgery. Our patient group was 55% female ( n = 30); the mean age was 47 years. Rib cartilage graft patients had significantly greater nasal pain than cartilage donor site pain. There was no significant difference in rib versus ear cartilage donor site pain. Nearly all patients reported that they were not at all concerned about their scar appearance or ear shape and appearance. No prior studies compare cartilage donor site morbidity in patients undergoing nasal surgery. Our findings challenge the conventional wisdom that utilizing auricular and costal cartilage results in high levels of donor site pain. Surgeons should have a low threshold to harvest rib or ear cartilage when it can improve surgical outcome.

Auricular Cartilage

2019 ◽  
pp. 91-94
Author(s):  
Ali Sajjadian
Keyword(s):  
Postoperative Pain ◽  
Donor Site ◽  
Graft Material ◽  
Cartilage Graft ◽  
Septal Perforation ◽  
Auricular Cartilage ◽  
Structural Support ◽  
First Choice ◽  
Graft Donor ◽  
Ear Cartilage

The ear is generally not a first choice as a cartilage graft donor site for several reasons, none of which is valid. When the graft is harvested anteriorly, the scar is well-concealed as long as the incision is placed within the rim of the conchal bowl. And, although no site can provide as much cartilage as the rib, the auricle can provide a surprisingly large amount of graft material. There is also characteristically minimal morbidity with the harvest of auricular cartilage. This distinguishes it from rib cartilage harvest, which may be accompanied by significant postoperative pain and occasionally pneumothorax. In addition, septal harvest may cause bleeding, saddling of the nose symptomatic of septal perforation, and other airflow disturbances. The most important and major problem with ear cartilage is the flaccidity inherent in its structure. This makes it a poor choice when significant structural support is mandatory.

scholarly journals Long-Term Results of Autologous Auricular Cartilage Graft Applied in Anophthalmic Orbits Unable to Wear Prosthesis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Yi-Lin Liao ◽  
Shu-Ya Wu ◽  
Yueh-Ju Tsai
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Long Term Results ◽  
Chang Gung Memorial Hospital ◽  
Cartilage Graft ◽  
Auricular Cartilage ◽  
Prosthesis Fitting ◽  
Prosthesis Retention

In anophthalmic patients, shallow lower fornices make wearing ocular prostheses impossible and maintaining normal social activities difficult. This study retrospectively investigated the long-term surgical outcomes of autologous auricular cartilage grafting for contracted orbits. From 1995 to 2013, 29 anophthalmic contracture sockets with inadequate lower fornices and poor prosthesis retention presented to Chang Gung Memorial Hospital in Linkou, Taiwan, were treated using this surgical method. The success rate, aesthetic outcome, recurrence, and complications were analyzed. Among the 29 patients, 15 were women, 14 were men, their mean age was 45 years, and the mean follow-up time was 52 months (range = 6–159 months). Satisfactory lid position was achieved in 25 cases (86%), and lower fornix retraction recurred in four cases (14%). Neither donor site morbidity nor auricular deformity was noted during the follow-up period. Therefore, an auricular cartilage graft can be used successfully as a compatible spacer for anophthalmic patients with shallow lower fornices and prosthesis-fitting problems in long-term follow-up.

scholarly journals Regional Anesthetic Blocks for Donor Site Pain in Burn Patients: A Meta-Analysis on Efficacy, Outcomes, and Cost

2020 ◽  
Vol 28 (4) ◽  
pp. 222-231
Author(s):  
Katherine A. Grunzweig ◽  
Ji Son ◽  
Anand R. Kumar
Keyword(s):  
Side Effects ◽  
Regional Anesthesia ◽  
Meta Analysis ◽  
Donor Site ◽  
Single Shot ◽  
Burn Patients ◽  
Pain Scores ◽  
Donor Site Pain ◽  
Graft Donor ◽  
Site Pain

Background: Skin graft donor site pain significantly affects pain management, narcotic use, and hospital length of stay. This study is intended to evaluate the efficacy of regional anesthesia in the burn population to decrease narcotic consumption and to assess the impact on hospitalization costs. Methods: PubMed/MEDLINE, Embase, and ScienceDirect were searched with the following inclusion criteria: comparative studies, adult populations, burn patients, autologous skin grafting, regional nerve blocks, and traditional narcotic regimens. Outcomes assessed included narcotic consumption, pain scores, and opioid side effects. Meta-analysis obtained pooled values for morphine consumption and side effects. Cost analysis was performed using published data in the literature. Results: Final analysis included 101 patients. Cumulative morphine consumption at 72 hours was lower for patients treated with regional anesthesia versus patient-controlled analgesia (PCA; single shot 25 ± 12 mg, continuous regional 23 ± 16 mg, control 91.5 ± 24.5 mg; P < .05). Regional anesthesia decreased nausea/vomiting ( P < .05) and lowered subjective pain scores. Regional anesthesia interventions cost less than PCA, single shot less than continuous ( P < .05). Conclusion: Regional anesthesia at skin graft donor sites significantly decreases narcotic consumption in burn patients. Regional anesthesia is cost-effective, decreases side effects, and may result in shorter hospital stays due to improved pain management.

Repair of nasal septal perforations using local mucosal flaps and a composite cartilage graft

2001 ◽  
Vol 115 (1) ◽  
pp. 22-25 ◽  
Author(s):  
T. J. Woolford ◽  
N. S. Jones
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Observation Time ◽  
Cartilage Graft ◽  
Septal Perforation ◽  
Surgical Closure ◽  
Nasal Septal Perforation ◽  
Graft Donor ◽  
Conchal Cartilage Graft ◽  
Suitable Technique

The surgical closure of a nasal septal perforation is recognized as being particularly challenging. A series of 11 consecutive patients who underwent closure of a septal perforation using a mucosal flap/composite conchal cartilage graft technique are reviewed, and the surgical technique described. The size of the perforation repaired varied, with eight cases being 2 cm or more in diameter. There was no significant graft donor site morbidity and complete perforation closure was achieved in eight cases after a mean observation time of 19.8 months. These results suggest that this is a suitable technique for closing nasal septal perforation.

Use of Continuous Local Anesthetic Infusion in the Management of Postoperative Split-Thickness Skin Graft Donor Site Pain

2013 ◽  
Vol 34 (4) ◽  
pp. e257-e262 ◽  
Author(s):  
Jorge L. Reguero Hernandez ◽  
Alisa Savetamal ◽  
Roselle E. Crombie ◽  
Walter Cholewczynski ◽  
Nabil Atweh ◽  
...  
Keyword(s):  
Skin Graft ◽  
Local Anesthetic ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Donor Site Pain ◽  
Thickness Skin ◽  
Graft Donor ◽  
Site Pain
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