A simple treatment for suppurative perichondritis

The Incidences of Chondritis and Perichondritis Associated With the Surgical Manipulation of Auricular Cartilage

“…Wound infection rates are increased in procedures involving the ear compared with other anatomic sites, even more so when surgical defects extend to the depth of cartilage 8 . Suppurative chondritis from P. aeruginosa infection, 17,18,24 besides requiring immediate medical treatment and complicated surgical interventions, 11,22–24 can produce a devastating and irreversible disfiguration of the ear. Such injury has resulted from burns, 9–11 high ear piercing, 12–17 acupuncture, 18–20 and surgical procedures 21–23 …”

“…The infection rate was even higher (28.5%) when the surgical defect extended to the depth of cartilage. Numerous cases of auricular perichondritis and chondritis have been reported after burns, 9–11 penetrating trauma to the ear cartilage from high ear piercing, 12–17 acupuncture, 18–20 and various surgical procedures 21–23 . Inflammation of the perichondrium or cartilage after such trauma predisposes to tissue ischemia and the development of Pseudomonas infection, which may ultimately lead to a suppurative chondritis 17,18,24 .…”

Perichondritis of the auricle and its management

“…Suppurative perichondritis has also been described following mastoid surgery 6 and as a complication of a burns injury. In uncomplicated cases, only a limited portion of the cartilage is usually involved, whereas in burns the cartilage damage is more generalised.…”

“…10 However, in more advanced cases, wide excision, with a composite resection of the overlying skin, necrotic cartilage and diseased perichondrium but preserving the skin of the contralateral surface, may be necessary. 6 Dowling et al advocated modifying the procedure by excising the necrotic material through a helical incision and by splitting the ear in a bivalved fashion. 11 These procedures require repeated debridement and prolonged treatment, and there is frequently loss of cartilage and a severe residual deformity.…”

Applied Basic Science of the Auricular Cartilage

“…In addition, intact perichondrium adds to the problem because it does not allow the inflammatory edema of the cartilage to expand, increasing the pressure on the cartilage which causes more necrosis and end up with cauliflower ear [37]. This pathophysiology must be applied clinically by immediate drainage of abscess and hematoma, and adequate debridement of any dead cartilage [38].…”