Ear lacerations

2 Feb

CAN YOU WIGGLE YOUR EARS?
–The musculature of the ear, if damaged, is of no significant importance
Generous dual blood supply = heals well
–Need to cover exposed cartilage and minimize wound hematoma

WHEN TO REFER TO PLASTICS/ENT:

  • Auricular hematoma
  • Involvement of auditory canal
  • If Humpty Dumpty is hard to identify:
    • Large skin avulsion (>5mm)
    • Large cartilage defects
    • Severe crush injury
    • Complete or near complete avulsion or amputation
    • Obvious devitalization
           
IF YOU FIX IT:
try regional nerve blocks or field blocks
–Avoid local anesthesia –> causes pain and distorts landmarks
–No good evidence to show the epinephrine causes ischemic necrosis
HEALS GREAT, LESS FILLING:
–The skin and underlying cartilage adhere to each other well, so that separate closure of cartilage is usually unnecessary
–only approximate cartilage separately from skin when the wound is extensive
–Apply pressure dressing to avoid hematoma formation
Submitted by J. Gullo.

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