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Infection after Medpore Ear Reconstruction for Microtia. What to do?

An infection after a Medpore Ear Reconstruction for Microtia can be an early complication that requires immediate attention and care. Superficial cutaneous infection and cellulitis can be treated with oral antibiotics. Deeper infection may involve an accumulation of pus. Patients usually present with pain, swelling, redness and loss of ear definition. Removal of the implant via a post-auricular incision or an “antihelical” incision, debridement of the pocket using a curette, a wash out of the pocket with an antibiotic solution and replacement with a newly formed implant is the treatment of choice. Once removed, the old implant is submerged in alcohol and is used as model for the carving of the new implant. The new implant is insetted in the freshly debrided and irrigated pocket. Cultures of the purulent discharge are also taken to choose the appropriate antibiotic-therapy. We try to prevent infections by adhering to a strict sterile procedure, providing antibiotics at the beginning of the procedure and every 4-hours, change of gloves when working on the implant and prescribing a 7-day course of antibiotics post-operatively (first generation cephalosporin).

Late infections are also rare. Most commonly, they would occur after a penetrating trauma. It would present with swelling, erythema, and loss of definition due to either swelling of the tissues or accumulation of subcutaneous/subfascial pus or both.

Removal of the implant via a post-auricular incision or an “antihelical” incision, debridement of the pocket, a wash out of the pocket with an antibiotic solution and replacement with a newly formed implant is the treatment of choice. Once removed, the old implant is usually submerged in alcohol and is used as model for the carving of the new implant. The new implant is insetted in the freshly debrided and irrigated pocket.

It is preferable to replace the implant and not just remove the implant and wash the pocket, since the flap will contract significantly and it will be hard to inset afterwards a new implant. In this unfortunate setting, an occipital flap is harvested to perform the secondary ear reconstruction.

If you have any questions about Microtia reconstruction or complications associated with it, come and visit us. Dr. Tahiri will discuss with you in depth the matter and will talk to you about the risks, benefits and alternatives associated with Microtia Reconstruction.

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