Assessment of Pain, Healing Time, and Postoperative Complications in the Healing of Auricular Defects After Secondary Intent Healing Versus Split Thickness Skin Graft Placement

Abstract

BACKGROUND Reconstruction of auricular defects after Mohs surgery is challenging given the prominence of the ear and its complex 3-dimensional architecture. OBJECTIVE Evaluation of postoperative pain, healing time, and postoperative complications of auricular defects after split-thickness skin graft (STSG) placement versus secondary intent healing (SIH). MATERIALS AND METHODS During this prospective, observational study, 30 patients recorded their daily maximum postoperative pain using the numeric pain rating scale from postoperative days 0 to 8. Surgical site healing was assessed at postoperative day 8 and 30. All postoperative complications were collected during the 30-day follow-up window. RESULTS Patients undergoing STSG experienced significantly more pain during the first 3 postoperative days than patients in the SIH group. Maximum pain was experienced on the night of surgery, with a mean pain score of 3.6 in the STSG groups versus 0.8 in the SIH group. Healing was significantly faster in the STSG group, with 87% of patients fully healed at 1 week versus 21% in the SIH group. No major complications were experienced in either group. CONCLUSION Split-thickness skin graft and SIH healing are well tolerated and provide excellent repair choices for auricular defects.