Microvascular ear replantation: a multicenter study of 22 patients with complete ear amputation
Multicenter study published in Facial Plast Surg Aesthet Med (2021)
Abstract
Background: We aimed to report our experience in treating ear amputations with microvascular replantation, with the largest sample to date. Methods: Twenty-two patients with complete ear amputation underwent microvascular ear replantation at three medical centers between May 2003 and May 2020. Arterial anastomoses, venous anastomoses, or vein graft were performed depending on different situations. Re-exploration was performed in four patients due to venous congestion (n = 3) or arterial compromise (n = 1). Results: Eleven patients had vascular complications (venous congestion: 10, arterial compromise: 1) and four of them required re-exploration. Three ears were completely salvaged (75%) and one case failed. Eighteen (81.8%) replanted ears survived completely, with 15 repaired ears demonstrating a good contour and 3 ears showing atrophy. Three replanted ears sustained partial loss, and one sustained total loss. Three extraordinary cases with the longest ischemic time, smallest tissue size, and youngest age reported thus far all survived and had cosmetically satisfactory appearances. Statistical analysis indicated no significant correlation between replanted ear survival and potentially influential factors, including ischemic time, number of arterial and venous anastomoses, presence of vein graft, and re-exploration. Conclusions: Microvascular replantation for ear amputations achieved excellent results. It may be considered the primary choice for surgeons with microsurgical skill.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Largest-to-date series of 22 microvascular ear replantations across 3 centers. 81.8% complete survival; 11/22 had vascular complications including 10 venous congestion cases.
Why This Matters for Hirudotherapy
This multicenter study reports outcomes of microvascular ear replantation in 22 patients with complete ear amputation, achieving an 81.8% complete survival rate. Venous congestion was the most common vascular complication (10 of 22 patients). The study makes no mention of leech therapy or hirudotherapy. While ear replantation complicated by venous congestion is a clinical scenario where medicinal leeches are sometimes employed adjunctively, this study does not describe any leech-related intervention. Relevance to ASH's domain is indirect, limited to the surgical context where venous congestion management challenges arise. The focus is on surgical technique and outcomes rather than adjunctive congestion therapies.
Citation
Microvascular ear replantation: a multicenter study of 22 patients with complete ear amputation.
Jiang Y et al. · Facial plastic surgery & aesthetic medicine, 2021
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