Skin necrosis after local anaesthesia with added epinephrine during otopexy

Background Capillary vasospasm is a rare complication after the application of local anaesthetic with epinephrine additive and may lead to necrosis of the affected skin areas. The case of a 17-year-old patient demonstrates the severity of the potential complications and the need for comprehensive information, especially in cosmetic procedures.

Material and methods The case report of a young healthy patient is presented in whom bilateral skin necrosis had developed after injection of prilocarpine hydrochloride 1% with epinephrine hydrogen tartrate 1:200000 into the non-pre-damaged skin of the anterior auricular surfaces. The event was discussed after an extensive literature review.

Summary The application of local anaesthetics with added epinephrine into the auricles can pose a potential risk for the development of skin necrosis for any patient and should be emphasised in the presurgical preparation, especially in the case of cosmetic procedures. In the case of our patient, secondary wound healing over the exposed cartilage resulted in an acceptable outcome without the need of any additional surgical intervention. Nevertheless, it is also important to avoid these rare cases in the interest of both -physician and patient.

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Artikel online veröffentlicht:
12. Mai 2023