Managing Refractory Infection and Suicide Risk After Auricular Reconstruction

J Craniofac Surg. 2026 Apr 7. doi: 10.1097/SCS.0000000000012654. Online ahead of print.

ABSTRACT

RATIONALE: Multidrug-resistant organism (MDRO) infection following auricular reconstruction is uncommon, but it can severely compromise reconstructive outcomes, especially when associated with an increased risk of suicide.

PATIENT CONCERNS: A 39-year-old man developed a refractory MDRO infection following post-traumatic autologous costal cartilage auricular reconstruction, experiencing severe depressive symptoms with suicidal ideation (peak PHQ-9 score: 25).

DIAGNOSES: Postoperative MDRO infection and major depressive disorder with high suicide risk.

INTERVENTIONS: An integrated, safety-centred nursing approach was implemented, including: individualised wound care; multidisciplinary antimicrobial management; multimodal pain control; continuous suicide risk assessment.

OUTCOMES: After 117 days, the infection was under control, and ∼40% of the reconstructed cartilage had been preserved. Laboratory markers normalised, the PHQ-9 score decreased to 8, and the patient was discharged with no suicide risk.

LESSONS LEARNED: Integrated nursing care can support surgical salvage by stabilising infection and psychological status, thereby improving safety and outcomes in complex auricular reconstruction.

PMID:41945335 | DOI:10.1097/SCS.0000000000012654