Objective: Arteriovenous malformations (AVM) of the ear show unique features. Progressive growth or inadequate management of AVMs may lead to bleeding, infection, cartilage exposure, and ultimately loss of structure. Total ear amputation is an alternative; however, due to the structural complexity of the ear, reconstruction is technically challenging. This study presents a treatment algorithm based on a clinical series, with treatment options including resection and immediate and late reconstruction.Methods: Between 2004 and 2018, 12 patients with auricular AVMs were treated with AVM resection and ear reconstruction at our hospital. Among these 12 patients, seven were women, and patients' ages ranged between 4 and 34 years. Parameters considered before resection and reconstruction were compromised ear extension (partial, total, or extra-auricular involvement), thickness (cutaneous and cartilaginous), symptoms (bleeding, infection, ulceration, and/or cartilage exposure), and preoperative embolization. Total resection of AVMs was planned as the first step in all cases, followed by primary closure. AVM resection was categorized into a partial or total procedure, resulting in partial or total ear defects. Reconstruction was categorized as immediate or delayed.Results: Preoperative embolization was performed in 10 patients. AVMs were totally removed, resulting in seven total ear amputations. In six of these patients, total ear reconstruction was performed 6 months later, and all patients were recurrence-free. Only one patient did not undergo ear reconstruction. Regrowth was not observed in any reconstructed ear.Conclusion: Treatment of ear AVMs requires a planned approach to achieve favorable clinical outcomes and for concomitant safe and definitive reconstruction.

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PLASTIC SURGERY 2015, Abstract Supplement 166 and/or differentiation capacity (DC); and determine if (2)human platelet rich plasma (PRP) can be used to promote the attachment and proliferation of ASC on an ECM. METHODS:Freshly isolated ASC from 3 individuals were cultured at 4 different seeding densities (n=4) ranging from 500 cells/cm2 to 5000 cells/cm2. Cell numbers were determined at 90% confluence to calculate PDT and PD. Osteogenic, chondrogenic, and adipogenic DC were measured by Alizarin red, Alcian blue, and Oil red O staining, respectively. Freshly isolated PRP from 3 individuals (n=3) or phosphate-buffered saline (PBS) (n=3) was pre-incubated on ECM before seeding with ASC. MTT assays were utilized to assess cell attachment at day 1 and cell proliferation at day 7. RESULTS: ASC were cultured for 9 to 31 days prior to 90% confluence and no significant differences in growth rates were observed among individual specimens and overall for PD 1.6 to 6.2 (n=4, p=0.184) (Fig. 1). The DC over PDs 1.6 to 6.2 also showed no significant changes (osteogenic, n=3, p=0.472; chondrogenic, n=3, p=0.878; adipogenic, n=3, p=0.256). PRP treatment significantly increased cell attachment on ECM (P<0.001) and also significantly increased proliferation compared to the PBS controls across all samples (P<0.001) (Fig. 2). Figure 1. Cell Growth Rate: Population doubling time (PDT) observed among seeding densities 500 cells/cm2 to 5000 cells/ cm2 (n=4, p=0.184).Figure 2. Cell Attachment and Proliferation: Significantly increased MTT readings across all groups (PBS:PBS, PRP:PRP, All:All) (n=3, P<0.001). Significantly increased cell presence demonstrated after 7 days (n=3, P<0.001). CONCLUSION:Our results demonstrate that in vitro expansion of ASC within the PD range 1.6 to 6.2 causes no significant change in cell growth rate or regenerative capacity. This suggests in vitro expansion prior to clinical application in this PD range is both safe and effective. Also, PRP treatment was shown to significantly improve ADSC attachment and proliferation on an ECM. We hope that this information will benefit ASC application to ECM in future in vivo studies and clinical applications. REFERENCES:1. Phillips BT, Bishawi M, Dagum AB, Bui DT, Khan SU.A systematic review of infection rates and associated antibiotic duration in acellular dermal matrix breast reconstruction. Eplasty. 2014;14:e42.2. Iyyanki TS, Dunne LW, Zhang Q, Hubenak J, Turza KC, Butler CE. Adipose-derived stem-cell-seeded non-crosslinked porcine acellular dermal matrix increases cellular infiltration, vascular infiltration, and mechanical strength of ventral hernia repairs. Tissue engineering Part A. INTRODUCTION:Melanomas present less frequently in the heel than other areas of the body and are often diagnosed at a later age. The plantar heel accounts for a little over 50% of plantar foot locations, and the lesion is composed mainly of acral lentiginous melanoma. The heel fat pad poses significant

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