Merocel Semicompressive Dressing to Prevent Donor-Site Hematoma on the Conchal Cartilage Graft

Abstract

Conchal cartilage grafts are commonly used in rhinoplasties; however, complications related to the donor site, including delayed wound healing and scar formation and hematoma formation, still occur. Hematoma formation is the most important and frequent complication. Conventional tie-over dressing with a bolster has been commonly used to prevent donor-site hematomas, but it does not always give satisfactory outcomes. Therefore, we have introduced a new compressive dressing technique using Merocel, which is cut in half transversely: 1 piece is used as a posterior bolster and the other piece is cut in half again (yielding 2 small pieces) to make a concavity in the conchal cartilage (one piece for cymba concha and the other piece for cavum concha, respectively). After application of Merocel, the overall complication and hematoma formation rates were significantly decreased. Our new compressive dressing technique using Merocel has several advantages. Merocel can absorb more secretions and discharge from the operative site than conventional dressings and there are no risks of tissue necrosis or ischemia due to suture tension. Also, because Merocel can be freely cut and molded and applies even pressure, it can be used on irregular surfaces. Our new compressive dressing technique using Merocel is a simple and reliable option for preventing auricular hematomas.