(A212) Comparing Bolstering and Mattress Suturing of Auricular Hematomas: A Systematic Review

Introduction: Auricular hematomas form in the subperichondrial space and are commonly seen in the emergency department after blunt trauma. Delay in treatment can lead to ischemia and necrosis of the cartilage, and thus drainage is promptly required. After drainage, it’s recommended to place pressure for up to a week, with various techniques available. This review looks at the current literature on the efficacy of mattress suturing and bolstering in terms of re-accumulation rates and patient satisfaction.

Methods: We performed a literature search using PubMed®, identifying studies that used either mattress suturing or bolstering in auricular hematoma repair. The efficacy of both methods was analyzed.

Results: We identified 9 studies that discussed either bolstering or mattress suturing. One study found bolstering had a rate of re-accumulation of 23.33% (p = 0.03) while mattress suturing had a rate of re-accumulation of 25% (p = 0.710). Other studies have looked at each technique individually, often with high patient satisfaction rates and low rates of recurrence. In one study, mattress suturing was superior to I&D with wick placement, while another study found a 14% recurrence rate when using bolstering compared to 60% without bolstering (p < 0.001).

Conclusions: Both mattress suturing and bolstering have shown to be efficacious treatments for auricular hematomas. One study in the literature directly compared both techniques and found bolstering to be superior. However, studies that looked at mattress suturing individually have found it to be an effective treatment. Further research is needed to directly compare both techniques.