Secondary intention, primary closure, and full thickness skin grafts can handle the majority of ear closures. Transposition flaps work nicely at the root of the helix, the preauricular area, the intertragal notch and the postauricular area. Helical rim advancements and their variations are the workhorse for repairing and restoring the natural arch of the helix. Retroauricular 2-stage pedicle flaps with or without a cartilage graft will provide a nice cosmetic result for larger defects involving the helical rim. Remember, most importantly, know your wound, know your patient, and the simplest closure is often the best one.
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