Traumatic bilateral subtotal auricular amputation

Introduction

In 2020, 689,656 reportable occupational accidents occurred in German workplaces, of which 7.6% involved injuries to the head region. Bilateral large soft tissue injuries of the auricles are the exception in this group. In order to achieve a replantation with a good result, a consistently timed planning of the treatment is recommended.

Case presentation

We present a 44-year-old female patient who used a forklift truck in the course of her work and got her head caught between the forklift cabin and a concrete column while manoeuvring the truck in a narrow space between high shelves. When the forklift was reversed, the patient's head was exposed to various shearing movements. After orientating polytrauma CT and physical examination, a bilateral subtotal auricular amputation was revealed. Direct surgical replantation with simultaneous bilateral treatment by several surgeons was performed. An auricle-preserving and good aesthetic result was achieved on both sides.

Conclusion

To shorten ischaemia times, adaptation or (and) reconstruction of major soft tissue injuries should be performed quickly and simultaneously. The anamnestic and diagnostic measures performed to exclude more serious concomitant injuries should be limited to the most necessary. In our opinion, the priority is to act quickly and avoid delays.The use of local anaesthetics with the addition of adrenaline or other vasoconstrictors should be avoided. Especially in the case of injuries to the head and face, an aesthetic reconstruction with the best possible outcome for the patient is of utmost importance.

Publication History

Article published online:
24 May 2022