Donor-Site Morbidity Following Harvest of Autologous Costal Cartilage in Microtia Reconstruction
Donor-Site Morbidity Following Harvest of Autologous Costal Cartilage in Microtia Reconstruction作者机构：Plastic Surgery Hospital of Chinese Academy of Medical Science Peking Union Medical College Beijing China Nepal Plastic Cosmetic and Laser Center Kathmandu Nepal
出 版 物：《Modern Plastic Surgery》 (现代整形外科（英文）)
年 卷 期：2024年第14卷第4期
页 面：57-73页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Chest Wall Autologous Costal Cartilage Deformity Microtia
摘 要：Objectives: The objective of this study is to evaluate donor-site morbidity after costal cartilage harvest for microtia reconstruction. Methods: A total of 70 patients who underwent autologous costal cartilage harvest for microtia reconstruction from March 2008-March 2009 were included. Anterior chest wall deformity was evaluated with chest topography, and scar quality at baseline and at 6-months follow-up, and final outcomes analyzed with SPSS. Results: In 70 patients, 52 (74%) were male, 18 (26%) were female, and altogether 40 (57%) patients developed deformity. At 6-month follow-up, the incidence of anterior chest wall deformity was highest at 80% in Block-III, and least at 0% in Block-I. The 6 - 10 years age group was the largest group at 84% (21), and also with highest incidence of deformity in association to Block-IV harvest at 83%. The incidence of donor-site deformity was higher in female gender at 66%, and 54% in males. But in the sub-group, male had higher incidence of deformity at 75% in both Block-III, and Block-IV when compared to the respective females. The 120 - 135 cm height group had the highest deformity at 67% with Block-IV costal cartilages harvested. At the three measurement points: 1) xiphisternum, 2) intersecting points between PSL and LCM, and 3) intersecting points between MCL and LCM, significant differences (mean) were observed in chest circumference from baseline to 6-month follow-up, and between the left and right chest hemi-circumference (postoperatively). Acceptable donor-site scar was observed in all but 3% (2) developed hypertrophic scar. Conclusion: The development of chest wall deformity was observed when more than one costal cartilage was harvested, particularly the 6th (complete), 7th, 8th block. Therefore, to minimize the deformity, we recommend harvesting only the necessary amount of cartilage, and at the lowest level possible to avoid injury of costochondral junction. Additionally, age, height, gender and chest development are
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