3.07 Split Earlobes
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agk's Library of Common Simple Emergencies

Presentation
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A patient will present with an earlobe split by 
a sudden pull on an earring.

What to do:
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- Excise the skin edges on both sides of the 
   wound, leaving the apical epithelium intact. 
   Suture these freshened wound edges together 
   using a fine monofilament material.
- If the patient wants to maintain a pierced 
   ear lobe, tie a loop of sterile suture 
   material through the hole to maintain a 
   tract while the rest of the lobe heals.
- Provide tetanus prophylaxis if needed.

What not to do:
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- Do not suture the wound primarily. The edges 
   may epithelialize, resulting in the split 
   redeveloping after the sutures are removed.

Discussion
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There are many techniques for the repair of 
split earlobes. Some methods, including this 
one, attempt to preserve the earring hole while 
others use a Z-plasty on the free margins of 
the lobes to prevent notching at the points of 
reunion. Depending on the specific circum- 
stances, it may be advisable to consult with a 
plastic surgeon before attempting to repair 
this type of earlobe injury.

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 from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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