Non-microvascular successful management of near-total ear avulsion
Case report published in Plast Reconstr Surg Glob Open (2021)
Abstract
Traumatic ear avulsion represents a difficult challenge for all reconstructive surgeons; hence, replantation and reattachment will provide the best aesthetic outcome. However, when microsurgery is not possible, the surgeon must choose the most appropriate alternative method to address the concern. We are reporting a case of a near-total right ear external auricle amputation attached only by small skin bridge. The patient was admitted to our institute 22 hours after sustaining an injury during a motor vehicle collision. He was successfully managed by reattaching the external auricle into the anatomical place, with the repair of cartilage. This was followed by applying a daily protocol for venous congestion with the use of subcutaneous and intradermal injection of low-molecular-weight heparin daily for 10 days with gradual tapering of the dose. The external auricle survived with no complications or morbidity. Subcutaneous and intradermal low-molecular-weight heparin can be used effectively in cases of severe venous congestion of avulsed ear with adequate arterial inflow without causing any morbidity.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Near-total ear avulsion managed by reattachment without microsurgery, with venous congestion controlled by daily subcutaneous + intradermal low-molecular-weight heparin for 10 days.
Why This Matters for Hirudotherapy
This case report describes a patient with near-total ear amputation managed by non-microvascular reattachment followed by a 10-day protocol of subcutaneous and intradermal low-molecular-weight heparin to address venous congestion, with the ear surviving without complications. The topic is indirectly relevant to ASH's domain because venous congestion following tissue reattachment is a clinical scenario where medicinal leeches are sometimes used as an alternative or adjunct. However, this study employed a pharmacological approach rather than leech therapy, and no leeches were involved. This is a single case report, and the heparin protocol does not directly inform hirudotherapy practice, though it addresses the same clinical problem leeches target.
Citation
Non-microvascular successful management of near-total ear avulsion.
Albdour M et al. · Plastic and reconstructive surgery. Global open, 2021
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