Repair of a Large Full-Thickness Conchal Bowl Defect

Large full-thickness conchal bowl defects pose a unique reconstructive challenge, particularly in patients who prioritize single-stage surgical solutions. While options such as wedge excisions, composite grafts, and interpolation flaps have been utilized, each has limitations for large defects in which structural integrity and cosmetic outcome are paramount. We present a case of a 77-year-old man with a 2.0×3.6-cm full-thickness defect of the right conchal bowl following Mohs micrographic surgery for cutaneous squamous cell carcinoma. Reconstruction was achieved using a single-stage, full-thickness hinge flap with a Burow graft. Our case highlights the utility of hinge flaps as a reliable and cosmetically favorable single-stage alternative for large conchal bowl defects.

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Publication Details

Journal
Cutis
Published
2025-05-01
DOI
https://doi.org/10.12788/cutis.1208
Primary Topic
Shoulder and Clavicle Injuries
Type
article
Field-Weighted Citation Impact
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article

Repair of a Large Full-Thickness Conchal Bowl Defect

Devon Barrett
Cutis
Shoulder and Clavicle Injuries
article

Repair of a Large Full-Thickness Conchal Bowl Defect

Devon Barrett
article en

Abstract

Large full-thickness conchal bowl defects pose a unique reconstructive challenge, particularly in patients who prioritize single-stage surgical solutions. While options such as wedge excisions, composite grafts, and interpolation flaps have been utilized, each has limitations for large defects in which structural integrity and cosmetic outcome are paramount. We present a case of a 77-year-old man with a 2.0×3.6-cm full-thickness defect of the right conchal bowl following Mohs micrographic surgery for cutaneous squamous cell carcinoma. Reconstruction was achieved using a single-stage, full-thickness hinge flap with a Burow graft. Our case highlights the utility of hinge flaps as a reliable and cosmetically favorable single-stage alternative for large conchal bowl defects.

CutisVol. 115(5)
Atlanta VA Medical Center (US)
Openalex Percentile: Top 81%
Shoulder and Clavicle Injuries
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