Replantation of amputated facial tissues with microvascular anastomosis
Case series published in Microsurgery (1994)
Abstract
A challenge to the microsurgeon is perfecting the technique of replantation of small pieces of facial tissue, mainly because of the extremely small size of the arteries as well as a lack of suitable veins for drainage. In the past 4 years, we have had seven cases of facial amputations, which included one scalp, two nasal tips, two ears, one lower lip, and one eyebrow. All of these patients were replanted/revascularized by microvascular anastomosis. Only two of the cases had suitable veins for anastomosis. Alternative techniques used for improving venous outflow were arterio-venous fistula, chemical leeches, and pin pricks. Four of the cases were completely successful, two cases had partial loss of the replant, and one case failed due to absence of venous drainage. In facial amputation, an aggressive microsurgical attempt will result in more tissue surviving and a better cosmetic outcome than in any other reconstructive procedures.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Seven cases of facial amputation (scalp, nasal tips, ears, lower lip, eyebrow) all underwent microvascular replantation/revascularization; only two cases had suitable veins for anastomosis, with alternative outflow techniques including chemical leeches and pin pricks.
Why This Matters for Hirudotherapy
This report describes seven facial amputation cases over four years—including scalp, nasal tip, ear, lip, and eyebrow injuries—that were replanted or revascularized by microvascular anastomosis. Only two cases had suitable veins for anastomosis, and arterio-venous fistula, chemical leeches, and pin pricks are listed as alternative techniques used to improve venous outflow. Four cases were completely successful, two had partial replant loss, and one failed due to absent venous drainage. The abstract mentions chemical leeches only as one alternative venous-outflow measure and provides no details on what it involved, when it was chosen, or outcomes attributable to it. Caveat: the article primarily concerns microsurgical replantation technique; live leech therapy is not discussed, so relevance to hirudotherapy is minimal and indirect.
Citation
Replantation of amputated facial tissues with microvascular anastomosis.
Jeng SF et al. · Microsurgery, 1994
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