d. Incision, drainage, and pressure bandage
(Sabiston, 15/e, pp 1277–1278.) A subperichondrial hematoma in the pinna of the ear may lead to avascular necrosis of the cartilage with shriveling of the pinna and fibrosis and calcification of the hematoma. The result is the deformity known as “cauliflower ear.” Appropriate treatment consists of evacuation of the hematoma by incision and tight packing of the skin and perichondrium onto the cartilage with a pressure dressing. Needle aspiration does not effect adequate drainage. Ice packs may be helpful early, but are not sufficient to prevent the deformity; antibiotics are not indicated for this lesion. Since the hematoma is subperichondrial, excision of the hematoma would remove the perichondrium and lead to cartilage deformities.