Free cartilage grafts for alar defects coupled with secondary-intention healing.

摘要

A rectangular skin flap is incised over the antihelix or conchal bowl and retracted to expose the cartilage. The rectangular incision creates a bigger window through which the cartilage is more easily excised than a simple linear incision and does not seem to compromise the aesthetics of the skin closure at the donor site. Although cartilage may be harvested from the conchal bowl or antihelix, using the conchal bowl for the cartilage batten will result in less-noticeable contour distortion of the donor site and is our current preference. Care is taken to preserve the perichondrium, and the cartilage batten is then placed into sterile saline while hemostasis is achieved at the donor site. The donor site flap is sewn back in place using a running cutaneous suture technique with 5-0 fast-absorbing gut (Ethicon, Johnson 8c Johnson, Cornelia, CA).