A Novel Syringe-Based Closed Suction System for Enhancing Skin Adherence in Microtia Reconstruction

In autologous microtia reconstruction, achieving optimal skin adherence to the cartilage framework is critical for aesthetic success. This study validates a novel, low-cost closed suction system assembled from a 20 mL syringe, a 5 mL syringe barrel acting as a rigid internal lock, and a fenestrated butterfly cannula. In a prospective cohort of 100 consecutive cases, the system effectively coapted the skin flap in all patients without major complications. Clinical data revealed a mean drainage duration of 6 days and 19 h (95% CI: 6 d 11 h to 7 d 4 h) and a mean collected fluid volume of 17.36 mL (95% CI: 16.77–17.95 mL). Blinded expert evaluation using the weighted 13-point Sharma scale demonstrated “Excellent” framework definition in 81.7% of patients. This system offers exceptional reliability and disruptive cost-efficiency, achieving stable vacuum pressure at a production cost of approximately 0.60 USD. These findings provide a compelling proof-of-concept for an accessible, high-performance alternative in auricular reconstruction, establishing a robust foundation for broader clinical adoption and future comparative validation in resource-limited surgical settings.