From the Guidelines
To repair a laceration of the helix of the ear, it is essential to clean the wound thoroughly and seek medical attention as suturing may be necessary to prevent infection and promote proper healing. When repairing a laceration of the helix of the ear, it is crucial to prioritize proper wound care to minimize the risk of complications, such as infection and chondritis, as the ear helix has limited blood supply and cartilage exposure increases infection risk 1. The first step is to clean the wound thoroughly with sterile saline or mild antiseptic solution, and then apply direct pressure with sterile gauze to control bleeding. For minor lacerations, apply antibiotic ointment and use butterfly closures or steri-strips to approximate the edges, covering with a non-adherent dressing. However, for larger or deeper lacerations, seek medical attention as suturing may be necessary, typically using 6-0 nylon or polypropylene sutures, with local anesthesia administered before suturing. Some key points to consider when repairing a laceration of the helix of the ear include:
- Cleaning the wound thoroughly with sterile saline or mild antiseptic solution
- Applying direct pressure with sterile gauze to control bleeding
- Using antibiotic ointment and butterfly closures or steri-strips for minor lacerations
- Seeking medical attention for larger or deeper lacerations, which may require suturing
- Administering local anesthesia before suturing
- Keeping the ear dry for 48 hours and applying antibiotic ointment daily for 3-5 days after repair
- Monitoring for signs of infection, including increasing pain, redness, swelling, or discharge, as the ear helix is prone to infection due to its limited blood supply and cartilage exposure 1.
From the Research
Laceration Repair of the Helix of the Ear
- The primary goal of laceration repair is to achieve hemostasis and optimal cosmetic results without increasing the risk of infection 2
- For lacerations of the helix of the ear, local anesthetic with epinephrine in a concentration of 1:200,000 is safe for use 2
- Irrigation with potable tap water rather than sterile saline does not increase the risk of wound infection, and nonsterile gloves can be used during laceration repair without increasing the risk of infection 2
- Tissue adhesives and wound adhesive strips can be used effectively in low-tension skin areas, but may not be suitable for the helix of the ear due to its curved shape and high tension area
- Wounds heal faster in a moist environment, and occlusive or semiocclusive dressings should be considered when available 2
Surgical Management of Ear Trauma
- Deformity or loss of the ear may be caused by superficial dermal burns or deep burns, and burn wounds of the ear should be debrided as early as possible 3
- A surgical procedure involving a postauricular advancement flap to cover the helix and a skin graft to cover the antihelix can be used to treat extensively burned ears 3
- The goals of treatment for ear trauma should be to restore the physiologic form and function of the ear, and middle ear injuries should also be addressed during the process 4
- Primary repair remains feasible in most cases, but delayed and staged reconstruction may be necessary to achieve successful results 4