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cartilage, and to prevent back-fracture of the cartilage as the surgeon

sews toward himself or herself.

3. Approximation of the Helix and Antihelix

Meticulous approximation of the helix and antihelix is necessary to

maintain structural and cosmetic integrity of the underlying framework.

This will help prevent an acquired auricular deformity.

4. Lacerations Involving the Free Edges of the Pinna

Lacerations involving the free edges of the pinna (i.e., helix, lobule)

require accentuated skin eversion with mattress sutures. This will help

prevent notching that may occur from scar contracture and depression

during the healing process (Figure 9.3).

5. Hematomas and Seromas

Hematomas and seromas require evacuation.

6. Perichondrial Coaptation to the Cartilage Framework

Plain gut sutures, chromic quilting sutures, or bolster dressings aid in

perichondrial coaptation to the cartilage framework and eliminate dead

space. This is crucial to maintain cartilage viability and prevent cauli-

flower ear or pseudocyst deformities.

7. Segmental Avulsion of the Pinna

For segmental avulsion of the pinna, the cartilage skeleton should be

deepithelialized and thoroughly cleansed to minimize bacterial load.

Figure 9.3

Right ear laceration closed primarily. Vertical mattress sutures used to

provide accentuated skin eversion. With scar maturation and retraction,

incision line flattens without significant notching of the rim.