Ear lacerations

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.

Reference(s): emedicine.com: complex ear lacerations, picture 1, picture 2, picture 3