Artery-Only Ear Replantation in a Child: A Case Report With Daily Photographic Documentation
Case report published in Eplasty (2016)
Abstract
Objective: Ear replantation poses a significant technical challenge even for the skilled microsurgeon. Many ear amputations result from avulsion and thus have damaged and often diminutive vessels with a paucity of veins. Artery-only replantation is an option for ear salvage, but little is published on the clinical course and appearance after this procedure. Methods: A subtotal ear replantation was performed on a 10-year-old boy without a venous anastomosis. Leech therapy was used to manage venous congestion postoperatively, and daily photography was performed to document the clinical course. Results: Postoperative venous congestion was successfully managed with leech therapy. Four days after the replantation, arterial thrombosis occurred that required a take back and salvage with an interposition vein graft for arterial repair. Native venous drainage and arterial revascularization from skin edges were evident by postoperative day 12, and leeches were discontinued on day 14. The patient required debridement of the posterior ear and superior helix necrotic skin, with burying of the upper portion of the ear in a superior auricular skin flap. The ear was subsequently released from the head, and the exposed portions were covered successfully with a full-thickness skin graft. Conclusions: While arterial and venous anastomoses should always be attempted, arterial-only ear replantation can provide excellent results when venous congestion is properly managed. Daily photography can be a useful tool to monitor subtle skin color changes that may indicate native venous drainage and arterial revascularization.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Subtotal ear replantation in a 10-year-old boy without venous anastomosis; venous congestion managed with leech therapy for 14 days. Native venous drainage and arterial revascularization from skin edges established by postoperative day 12.
Warum dies für die Hirudotherapie relevant ist
This case report describes a 10-year-old boy who underwent subtotal ear replantation without venous anastomosis following amputation, with postoperative venous congestion managed using leech therapy over approximately 14 days. Arterial thrombosis occurred on day 4 requiring salvage with an interposition vein graft, and native venous drainage became evident by day 12. The patient ultimately required debridement of necrotic skin and a full-thickness skin graft but achieved a successful outcome. For ASH, this is directly relevant as it documents hirudotherapy used to manage venous congestion in artery-only replantation, a challenging microsurgical scenario. The caveat is that this is a single case report with no control or comparative data, and the clinical course involved multiple interventions, so the specific contribution of leech therapy to the final outcome cannot be isolated.
Zitation
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