American Society of Hirudotherapy

A comparison of ear amputation replantation techniques

Review published in J Stomatol Oral Maxillofac Surg (2023)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Observational studyClinical TrialsBaldini et al. · Journal of stomatology, oral and maxillofacial surgery, 2023

Abstract

BACKGROUND: The management of traumatic ear amputations remains a rare and difficult occurrence for surgeons. This is due to the fact that the chosen replantation technique must ensure the best vascular supply and the surrounding tissues have to be preserved as to not jeopardize a future auricular reconstruction in the event of replantation failure. OBJECTIVE: This study aimed to review and synthesize the literature about the different surgical techniques described to date in the management of traumatic ear amputations (partial or total). MATERIALS AND METHODS: Relevant articles were searched on PubMed, ScienceDirect, and Cochrane Library databases in accordance with the PRISMA statement guidelines. RESULTS: A total of 67 articles was retained. When possible, microsurgical replantation enabled the best cosmetic result but required important care. CONCLUSION: Pocket techniques and local flaps should not be performed because of the lower cosmetic result and the use of the surrounding tissues. However, they could be reserved for patients without access to advanced reconstructive techniques. When possible, microsurgical replantation can be attempted after patient consent for blood transfusions, postoperative care and hospital stay. Simple reattachment for earlobe amputations and ear amputations up to one third is recommended. When microsurgical replantation cannot be attempted, and if the amputated segment is viable and bigger than one third, simple reattachment may be attempted with an increased risk of replantation failure. In case of failure, an auricular reconstruction by an experienced microtia surgeon or prosthesis may be considered.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReviewComparative Study
Indexed MeSH termsReplantationHumansAmputation, TraumaticMicrosurgerySurgical FlapsEar, ExternalPlastic Surgery Procedures

Summary

Comparative review of ear-amputation replantation techniques including arterial-only and arterial-venous reconstruction with adjunctive leech therapy considerations.

Why This Matters for Hirudotherapy

This review and comparative study synthesized 67 articles on surgical techniques for managing traumatic ear amputations, concluding that microsurgical replantation offers the best cosmetic result when feasible, while pocket techniques and local flaps yield lower cosmetic outcomes. The abstract focuses on surgical technique comparisons, indications for different approaches, and management of replantation failure. For ASH's domain, the article has no defensible connection—leeches, hirudotherapy, and the leech secretome are not mentioned anywhere in the abstract. The review is relevant only to ear replantation surgical decision-making and provides no evidence regarding leech therapy.

Citation

A comparison of ear amputation replantation techniques.

Baldini et al. · Journal of stomatology, oral and maxillofacial surgery, 2023

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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