Microsurgical replantation of completely avulsed nasal segment
Case report published in J Craniofac Surg (2019)
Abstract
Complete avulsion of the nose is a devastating injury that may result in permanent disfigurement. Microvascular reattachment is technically difficult due to small size of the injured vessels, associated avulsion or crush injury, and relative inability to achieve venous anastomosis. This report describes a successful case of microsurgical replantation of the distal third of the nose in a 47-year-old patient after a dog bite injury with the use of a superficial temporal vein graft for arterial repair and leeching for venous outflow. The recovery was uneventful with total survival of the replant noted except for marginal skin necrosis, which healed by secondary intention. There was no need for any transfusion. The authors found that use of the superficial temporal vein for arterial revascularization was efficient and convenient as it was in the same surgical field, offering a favorable donor site scar in the preauricular sulcus. Microsurgical replantation should be attempted whenever feasible in cases of complete nose amputation.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
47-year-old patient with complete nose-tip avulsion successfully replanted via microsurgery using superficial temporal vein graft for arterial repair and leech therapy for venous outflow. No transfusion needed.
Why This Matters for Hirudotherapy
This case report describes successful microsurgical replantation of the distal third of the nose in a 47-year-old patient after a dog bite injury, using a superficial temporal vein graft for arterial repair and leeching for venous outflow. The recovery was uneventful with total replant survival except for marginal skin necrosis that healed by secondary intention, and no transfusion was required. This is relevant to ASH's domain as a documented clinical application of leeching for venous outflow management following nasal replantation where venous anastomosis could not be achieved. The honest caveat is that this is a single case report, no details about leeching duration, number of leeches, or species are given, and the relative contribution of leeching versus other factors to the successful outcome cannot be determined from the abstract.
Citation
Microsurgical replantation of completely avulsed nasal segment.
Akyurek M et al. · The Journal of craniofacial surgery, 2019
Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026