American Society of Hirudotherapy

Successful replantation of the ear as a venous flap

Case report published in Ann Plast Surg (2008)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsTrovato MJ et al. · Annals of plastic surgery, 2008

Abstract

Successful microvascular ear replantation is well described, and often involves the use of arterial inflow anastomoses with leeches and systemic anticoagulation to augment outflow. Failed replantation attempts have also been published, with most of the failures attributed to venous drainage problems. A case of successful replantation of an ear is presented using a single 0.5-mm arteriovenous anastomosis, as no suitable artery could be identified in the amputated part. Postoperatively, dextran and leech therapies were employed to promote adequate venous drainage. We report a 100% successful ear replantation using a single arterialized vein as the inflow. In situations where no adequate artery is identifiable in the amputated part, an arteriovenous anastomosis may be a suitable alternative.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAdultAmputation, TraumaticEarHumansMaleReplantationSurgical FlapsVeins

Summary

Adult male with avulsed ear successfully replanted via single 0.5 mm arteriovenous anastomosis; dextran and leech therapy salvaged the auricle.

Why This Matters for Hirudotherapy

This case report describes successful replantation of an avulsed ear using a single 0.5-mm arteriovenous anastomosis, with postoperative dextran and leech therapies employed to promote adequate venous drainage when no suitable artery was identifiable in the amputated part. The authors report 100% successful replantation using an arterialized vein as the sole inflow. This is directly relevant to ASH's domain, documenting medicinal leech therapy as an integral adjunct in ear replantation where conventional arterial repair was not feasible. However, this is a single case report without controls, and leech therapy was used in combination with dextran, precluding independent attribution of the successful outcome to leeching alone.

Citation

Successful replantation of the ear as a venous flap.

Trovato MJ et al. · Annals of plastic surgery, 2008

DOI

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

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.