American Society of Hirudotherapy

Complete ear replantation without venous anastomosis

Case report published in Microsurgery (1998)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsSafety & Infection ControlNath RK et al. · Microsurgery, 1998

Abstract

Traumatic amputation of the entire auricle is a rare occurrence. Management ideally consists of microvascular reconstruction of auricular arterial, venous, and nerve continuity. However, appropriately sized veins are often not available and venous drainage must be accomplished with leech therapy. In occasional cases where leeches are unavailable or cannot be made to attach, mechanical drainage and anticoagulation can give satisfactory drainage. The authors present a case of mechanical wick venous drainage of a complete ear replantation, resulting in virtually normal appearance and function of the ear. In addition, the ear regained normal touch and two-point sensibility, although the great auricular nerve had not been repaired.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAdultAmputation, TraumaticAnticoagulantsArteriesDrainageEar, ExternalHeparinHumansMaleReplantationVeins

Summary

Case of complete ear replantation with mechanical wick venous drainage and anticoagulation when leeches were unavailable; achieved virtually normal appearance and function.

Why This Matters for Hirudotherapy

This case report describes complete traumatic ear replantation in which venous drainage was managed with mechanical wick drainage and anticoagulation rather than leech therapy, because appropriately sized veins for anastomosis were unavailable and leeches could not be used. The authors note that leech therapy is the standard approach for achieving venous drainage when venous anastomosis is not feasible, but present mechanical drainage as an alternative when leeches are unavailable or fail to attach. For ASH, this article is relevant insofar as it positions hirudotherapy as the recognized first-line adjunct for venous congestion in ear replantation, while documenting a successful non-leech workaround. The study is a single case report and does not directly evaluate leech therapy outcomes.

Citation

Complete ear replantation without venous anastomosis.

Nath RK et al. · Microsurgery, 1998

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.