American Society of Hirudotherapy

Microsurgical replantation of an ear in a child without venous repair

Case report with literature review published in Plast Reconstr Surg (1998)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsConcannon MJ, Puckett CL · Plastic and reconstructive surgery, 1998

Abstract

Ear amputation can leave a devastating deformity; the application of microsurgical replantation techniques has allowed very favorable aesthetic outcomes when successful. We report a case of ear replantation in a child in whom a venous repair was not performed; instead medicinal leeches were used to decompress the ear in the immediate postoperative setting. This represents the third reported case of successful ear replantation without microsurgical venous anastomosis. A review of the literature reveals the high incidence of venous congestion requiring external decompression (57 percent) and the very high rate of salvage (80 percent) after replantation. Surgeons attempting ear replantation should be aware of the high rate of ear survival in the situation of no venous outflow (with appropriate decompression techniques) and should not abandon attempts at replantation because of the inability to establish venous outflow microsurgically.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsBites and StingsChildEar, ExternalHumansMaleMicrosurgeryReplantation

Summary

Third reported case of successful ear replantation without microsurgical venous anastomosis. Literature review found 57% incidence of venous congestion requiring external decompression and 80% salvage rate following replantation.

Why This Matters for Hirudotherapy

Establishes that ear replantation should be attempted even without feasible venous anastomosis, given high salvage rates with leech-mediated decompression.

Citation

Microsurgical replantation of an ear in a child without venous repair.

Concannon MJ, Puckett CL · Plastic and reconstructive surgery, 1998

Added to ASH library: May 26, 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.