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This study was intended to present methods for salvage perforation and infection of an expended skin flap in total ear reconstruction with autogenous costal cartilage.Between March 2008 and March 2009, 5 patients experienced complications (perforation and infection) after total ear reconstruction. The skin perforations were noted between 29 and 100 days after inflation. Continuous irrigation and suction drainage, local flap transposition, and pillow suturing were used to control the perforation and infection. Continuous irrigation and suction drainage, especially, should be maintained until ascertaining a negative conversion of the wound culture.Perforation and infection of the reconstructed ear with an expanded skin flap healed successfully using continuous irrigation and suction drainage, local flap transposition, and pillow suturing.We suggest that continuous irrigation and suction drainage with only minimal debridement of grafted autogenous costal cartilage could be satisfactory solutions for salvaging total ear reconstruction after complications.