Surgical outcome following primary closure of auricular lacerations

TL;DR

This study shows that closing ear lacerations in the emergency department often leads to good results, though helix injuries may lead to worse outcomes.

Contribution

The study introduces a new classification system to assess the success of auricle laceration closures.

Findings

60.7% of patients had full success with no irregularities after auricle laceration closure.

Helical involvement was associated with inferior surgical outcomes.

The classification system showed moderate agreement among observers (Fleiss’ kappa coefficient 0.570).

Abstract

To evaluate the aesthetic outcomes of primary closure of auricle lacerations in the emergency department.

In this prospective case study in our tertiary referral center we included all patients with an auricular laceration without complete avulsion. Wound treatment involved thorough cleaning and primary closure. Photos of the auricle were taken at various stages for evaluation. To evaluate the achieved results after 3 months, a success classification system with four classes was developed: (1) full success, no irregularities, (2) partial success, only minor irregularities, (3a) unsuccessful, major irregularities or (3b) unsuccessful, (partial) necrosis.

Most patients demonstrated successful outcomes (60.7% full success and 32.1% partial success), with helical involvement being associated with inferior results. The interobserver percent agreement of the classification system was 88%. The Fleiss’ kappa coefficient was 0.570, p < 0.001.

Primary closure of ear lacerations results in a high success rate. We have introduced a revised classification system to qualify the success of treatment of the auricle laceration. Involvement of the helix is correlated with inferior surgical results three months after surgical closure.

Trial registration number and date of registration: reference number W21_387 # 21.432, September 9, 2021.

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