Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature
Case report published in Plastic and Reconstructive Surgery Global Open (2018)
Abstract
BACKGROUND: Ear avulsion is a rare complication of different traumas, such as car accidents, human or animal bites and stab wounds, and can result in dramatic cosmetic consequences for the patient. Ear replantation, revascularization, and reattachment are the options offering best aesthetic results. But venous outflow insufficiency is responsible for a high rate of failures. Leeching is one the most efficient methods to relieve venous congestion. It has been used as an alternative venous outflow in case of severe impairment of the physiologic one. METHODS: We present a case of successful rescue of a congested reattached ear by leeching after subtotal avulsion, along with a review of the literature on cases of avulsed auricle reconstruction salvaged by hirudotherapy. Data were collected and analyzed to identify a best regimen to deal with venous congestion. RESULTS: More than 130 cases of avulsed auricle savage are described in the literature, in a fourth of which leech therapy was used in the management of venous congestion. DISCUSSION: In case of both venous outflow deficit or absence, leeches are a potentially successful option to correct the congestion while new veins reestablish normal physiology. The need for anticoagulant/antiaggregant therapy, antibiotics, and often blood transfusion are the main pitfalls of leeching. CONCLUSION: Leeches can be considered a salvage method for ear replantation and reattachment in those cases that lack venous outflow in the presence of valid arterial inflow.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Case of leech-mediated salvage of a congested reattached ear after subtotal avulsion with review of >130 published cases of auricle reconstruction salvage, identifying optimal leeching regimens.
Warum dies für die Hirudotherapie relevant ist
This article presents a case of successful rescue of a congested reattached ear by leeching after subtotal avulsion, accompanied by a review of the literature identifying over 130 cases of avulsed auricle salvage, approximately one quarter of which used leech therapy for venous congestion management. The authors conclude that leeches can serve as a salvage method when venous outflow is absent or impaired but valid arterial inflow exists. This is directly relevant to hirudotherapy, as leeches are described as one of the most efficient methods to relieve venous congestion and a potentially successful option while new veins reestablish normal physiology. The authors note that the need for anticoagulant/antiaggregant therapy, antibiotics, and often blood transfusion are the main pitfalls of leeching.
Zitation
Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature.
Facchin F, Lancerotto L, Arnež ZM, Bassetto F, Vindigni V · Plastic and reconstructive surgery. Global open, 2018
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