efficacy of negative pressure wound treatment using vacuum assisted closure technique combined with nano silver medical antibacterial dressing and recombinant bovine fibroblast growth factor gel for management of acute auricular chondritis

Abstract

Objective: We aim to explore the effective treatment and repair methods for Acute Auricular Chondritis (AAC) caused by non-burn injuries in its early stage and alleviate the great pain caused by diseases including cartilage infection and necrosis in the auricular while improving the quality of the patients’ lives as well as reducing the incidence of small ear malformation.

Methods: In the experimental group, 12 cases of AAC from 10 patients caused by external ear no-burn injuries were treated in our hospital since January 2015, all of the patients had no diabetes and rheumatoid immune related diseases. Vacuum Assisted Closure (VAC) technique with Nano-silver Medical Antibacterial Dressing (MAD, Acasin®) and Rb-FGF (Beifuxin®) gel was applied to the wound, and the auricle was shaped during the dressing process. We adjusted the negative pressure range of the VAC in the process of normalization (Details of the process can be seen in the Method of the article). In the control group, there were 6 patients (6 ears) that had non-burn AAC. Since these patients required conservative treatment, full course of antibiotic treatment of adequate dose were given while regular dressing changes were given to the ulcerated wound on time.

Results: 12 cases of AAC from 10 patients were healed thoroughly through leveraging standardized VAC technique combined with Nano-silver MAD and Rb-FGF gel treatment. Concurrently, the external ear structure was preserved completely and there was no major ear defect or ear cauliflower like deformity occurred in the auricle. The outer auricle was only slightly invaginated in the outer upper ear wheel, and the rest of the auricle was in normal shape. In control group, only 1 patient was healed with no recurrence after 3 months of follow-up visit. This patient’s auricle anatomy was normal and the cartilage elasticity was good while no related complications and sequel appeared. Conservative treatment was effective for 2 of the patients. After 3 months of follow-up visit, both of their left auricles contracted locally. For the rest 3 patients, the auricle contracture was relatively obvious, and the appearance of the ear was thickened. To note that, the overall effective rate of the control group was 50%.

Conclusion: Traditional incision and drainage for AAC caused by non-burn injuries often result in different degree of external ear deformities. Ear defects or cauliflower-like deformities not only make it difficult to reconstruct the external ear but also cause serious psychological injury to the patients. The novel standardized treatment prescription can treat AAC early and effectively, reduce the physiological and psychological pain of patients, and decrease the traditional treatment of external ear malformation caused by AAC significantly.

Keywords: Acute auricular chondritis; Non-burn; Nano-silver medical antibacterial dressing; Rb-FGF; VAC