Since 2001, 18 patients with large skin defects in the auricular cavity have been repaired with a one-stage grafting method using a dorsal auricular flap, with satisfactory results. 1. Data and methods 1.1 Clinical data Since 2001, 18 patients with skin defects in the auricular cavity, including 11 males and 7 females, aged 11-56 years, were seen in our department. The swelling was removed under local anesthesia in 12 cases, and the lesion was found to be limited to the skin layer with intact subcutaneous cartilage and a smooth, white surface. There were 6 cases of auricular trauma. The minimum skin defect of the auricular cavity was 1.5 cm × 1.0 cm and the maximum was 2.5 cm × 2.0 cm. 1.2 Methods After excision of the auricular cavity swelling or ear debridement, routine disinfection, spreading of towels, and local infiltration anesthesia with 2% lidocaine plus a little 0.1% epinephrine were done behind the ear and behind the ear. A curved incision is made along the back of the ear with the posterior sulcus as the diameter, and the width is equal to the diameter of the auricular cavity skin lesion, and the skin is cut and separated from the flap. The central part of the cartilage of the auricular cavity is excised, so that the auricular cavity is connected to the postauricular incision, and the postauricular tipped flap is pulled to the auricular cavity, and the skin around the defect is sutured to the wound without tension. The skin flap is fixed with sutures packed with pressure and the donor tissue is directly pulled together and sutured. Effective antibiotics and vasodilators were applied, and the stitches were removed 10 days after surgery. 2.Results The pressure packing was removed 7 days after surgery, the surface of the transplanted flap was red and all of them were viable. 10 days after stitch removal, a dark red hard crust was formed on the surface of the skin piece of the earnail cavity, the crust fell off after about half a month, and the flap was in good condition. 18 patients were healed in one stage, and the flap did not change. Postoperative observation for 6 to 12 months showed good surgical results and satisfactory appearance. Most of the muscular tissues of the auricle are thin, and the blood supply is not rich. For the repair of auricular defects, the commonly used methods are full skin grafting or local free flaps, etc. For auricular trauma with deformity, only debridement and suturing are often performed in the first stage, and the second stage grafting is performed after 6 weeks, but they all lack well-known blood supply arteries, and the flaps are prone to ischemic necrosis after grafting [1]. We used a dorsal auricular tipped flap to repair 18 patients with a large area of skin defect in the auricular cavity with a stage I graft, and all 18 patients healed in one stage with good flap condition and satisfactory appearance. Through the surgical treatment of these patients, we learned that the use of the dorsal auricular tipped flap to repair skin defects in the auricular cavity has the following advantages: from the anatomical relationship, the skin color of the dorsal auricular cavity is similar to that of the auricular cavity, and the postoperative scar is not obvious, which can fully meet the aesthetic requirements; the dorsal auricular flap is thin, easy to cut and shape, and there is no obvious deformity after repair; the blood supply of the tipped flap is good, the transfer angle of the tipped flap is small, the muscle flap is partially buried in the tunnel, and there is no span. The flap with tip has a good blood supply, small flap transfer angle, and a partially buried muscle flap in the tunnel without span, which makes the survival rate of the flap much higher; the tissue behind the ear is loose, which is conducive to the design and transfer of the flap; the operation is relatively simple, and the method is easy to learn as long as the design points are mastered; the donor area behind the ear is hidden and not easy to find, and the flap has little tension and is easy to survive, easy to dress, and easy to observe after surgery. Therefore, the dorsal auricular flap with tip is an ideal method for treating skin defects of the auricular cavity. The design of the flap during surgery should pay attention to its blood flow, and the skin should be cut in its entirety. The preoperative design must be accurate and in place with appropriate scales, and the sutures should be aligned and aligned to avoid excessive flap tension during surgery that may affect the postoperative healing of the flap [2]. Moderate postoperative bandaging not only increases the contact area between the flap and the cartilage, which is conducive to the establishment of blood supply, but also reduces the accumulation of blood and fluid under the flap and effectively prevents subcutaneous fluid accumulation in the auricle.