Use of Cultured Human Keratinocytes for the Management of a Complex Traumatic Auricular Wound

Introduction: Complex traumatic injuries of the external ear that cause devitalization with exposed cartilage which requires advanced treatment, as they can lead to both acute infectious complications and late problems related to deformity. Management of these cases usually requires reconstruction; however, conservative treatment is an option that may preserve function and restore the anterior and lateral contours without increasing risks or complications. Objective: Present a clinical case describing a novel application of cultured human keratinocytes for the management of a complex auricular wound. Methods: The clinical case of an 11-year-old female patient is presented. She sustained polytrauma with partial loss of the left auricle, 2 x 1.4 cm of exposed cartilage, and loss of skin continuity of the helix. Primary closure was performed, and keratinocytes were manually collected from the Epifast sheet and applied to the raw wound and exposed area. The aim is to present the procedure and its results in order to disseminate another management option that does not involve surgery. Results: Findings 2 weeks after the first application of Epifast showed cartilaginous exposure measuring 5 mm in diameter, so Epifast was applied again, achieving complete epithelialization of the exposed auricular cartilage at 5 weeks. At 6 months, epidermal thickening with good scar quality was observed; no complications occurred during follow-up. Conclusion: Application of keratinocytes promotes granulation tissue formation and re-epithelialization by secreting cytokines that modulate cell proliferation, migration, and differentiation during healing of ear wounds with exposed cartilage.