Split‐thickness skin grafting for reconstruction of auricular skin defects: a statistical analysis

The revolving door flap could be the reconstructive procedure of choice for the auricular concha following skin cancer excision, based on low risk of necrosis, infection, and postoperative hemorrhage and excellent aesthetic outcomes.

“Qualitative synthesis of the results concluded that the revolving door flap could be the reconstructive procedure of choice for the auricular concha, following skin cancer excision.”

STSG may be used as an alternative to the revolving door flap for conchal bowl reconstruction.

“STSG may be used as an alternative.”

STSG was one of two techniques to present cases of all complications.

“Among the various reconstructive methods examined by the included studies, STSG was one of two techniques to present cases of all complications [2,10,18].”

Overall, the risk of bias for the enrolled case series was low following assessment with the JBI Critical Appraisal Checklist for Case Series.

“Overall, the risk of bias for the enrolled case series was low following assessment with the JBI Critical Appraisal Checklist for Case Series [1,4,5,6,7,8,9,10,12,16].”

The best aesthetic results were achieved when using the revolving door flap or STSG.

“Although all existing reconstructive procedures yield acceptable aesthetic outcomes, the best results were achieved when using the revolving door flap or STSG [1,3,6,7,9,10,12].”

Thuile (2018) documented after STSG infection in 22.2% of patients (11.1% at donor site and 11.1% at receptor site) and postoperative hemorrhage in 11.1%.

“Thuile (2018) documented some cases of infection and postoperative hemorrhage, although the incidence of these was higher than in Wines (2001): 22.2% of patients developed an infection (11.1% occurring at the donor site, and the other 11.1% at the receptor site), and 11.1% of patients suffered from postoperative hemorrhage [2,10].”

Thuile (2018) did not identify any cases of altered scarring after STSG, and Futoryan (1996) did not find any cases of infection after STSG.

“On the contrary to the findings of Wines (2001), Thuile (2018) did not identify any cases of altered scarring, and Futoryan (1996) did not find any cases of infection [2,10,18].”

Not all included studies presented data on the two outcomes considered in this review.

“Not all included studies presented data on the two outcomes considered in this review [1,2,3,4,5,6,7,8,9,10,12,18].”

Aesthetic results were reported in a heterogeneous manner across included studies.

“while complications were presented in the form of incidences in all included studies, aesthetic results were reported in a heterogeneous manner [1,2,3,4,5,6,7,8,9,10,12,18].”

For STSG, Thuile (2018) reported average patient satisfaction of 9.78 out of 10, aesthetic outcome according to one dermatologist of 9.22 out of 10, and according to two plastic surgeons of 9.11 out of 10.

“The average patient satisfaction and the aesthetic outcome according to one dermatologist and two plastic surgeons was rated as 9.78 out of 10, 9.22 out of 10, and 9.11 out of 10, respectively [10].”

Most included studies had a long follow-up period, ensuring that even long-term complications and aesthetic defects were detected.

“For instance, most included studies had a long follow-up period, ensuring that even long-term complications and aesthetic defects were detected [1,2,3,4,5,6,7,8,9,10,12,18].”

STSG aesthetic outcomes were excellent from patient and surgeon perspectives, but cosmetic results were extracted from a single study with a reduced sample size and could be skewed.

“Despite these complications, aesthetic outcomes were excellent, both from patient and surgeon perspectives [10]. Nevertheless, cosmetic results were extracted from a single study with a reduced sample size, and as such, could be skewed [10].”

This review can provide a global perspective because it comprises studies from several countries conducted by different specialists.

“Moreover, this review can provide a global perspective as it comprises studies from several countries conducted by different specialists (dermatologists, otorhinolaryngologists, or plastic surgeons) [1,2,3,4,5,6,7,8,9,10,12,18].”

STSG should be favored over FTSG due to its comparatively lower incidence of complications and superior cosmetic results.

“Although STSG also has a proclivity to cause complications, it should be favored over FTSG due to its comparatively lower incidence of complications and superior cosmetic results [2,3,10,18].”

All existing reconstructive procedures applicable to the auricular concha were explored in this review.

“More importantly, all existing reconstructive procedures applicable to the auricular concha were explored [1,2,3,4,5,6,7,8,9,10,12,18].”