American Society of Hirudotherapy

Microvascular salvage of a thrombosed total ear replant

Senchenkov A, Jacobson SR (2013) · Microsurgery · n=1

RCT evidence detailTrial reference
GRADE Very LowInsufficient evidenceCondition: Microsurgical Replantation (Digit / Ear / Scalp) →
Sample size of this trial compared with other Microsurgical Replantation (Digit / Ear / Scalp) trialsArbel EJ 202446Secanho MS 202429Kameda Y 202525Arami A 201825Buntic RF 201019Chabridon AI 202613Battin AO 202312Hong Ha N 20254Pertea M 20213Senchenkov A 20131
This trial (highlighted) by sample size alongside other indexed Microsurgical Replantation (Digit / Ear / Scalp) trials. Larger trials generally carry more statistical weight.

Study Profile

Design
single-patient case report (45-year-old woman, total ear amputation from horse accident, Mayo Clinic Rochester)
Sample size (n)
1
Intervention
Total ear replantation with subsequent venous thrombosis managed with anticoagulation + leech therapy; arterial thrombosis at 80 hours required posterior auricular artery resection and saphenous vein interposition graft
Comparator
No control - single case
Primary endpoint
Total ear replant survival after thrombotic complications
Primary result
Successful microvascular salvage of thrombosed total ear replant with combination anticoagulation, leech therapy, and arterial revision with saphenous vein graft
Follow-up duration
Postoperative recovery + outpatient follow-up
PMID
23640855

Key Findings

  • Total ear replant survival after venous and arterial thrombosis
  • Leech therapy combined with systemic anticoagulation
  • 80-hour arterial thrombosis salvage with vein interposition graft
  • Multi-stage rescue protocol
  • Horse accident etiology highlights real-world trauma context

Limitations

  • Single case - case-specific lessons only
  • Cannot separate leech effect from systemic anticoagulation
  • Aesthetic outcome not described in detail
  • Limited follow-up reporting
  • Cannot generalize from horse accident mechanism

Clinical Implications

Senchenkov 2013 demonstrates how leech therapy integrates with systemic anticoagulation and surgical revision in multi-modal salvage of complex ear replant thromboses. For US clinicians under K040187, the case illustrates real-world combination protocols where the device is part of a layered rescue strategy rather than sole intervention.

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This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.