Partial reconstruction of the auricle with the tubed postauricular flap: a case report
Case report published in J Craniofac Surg (2024)
Abstract
The authors present a case of a partial auricular deformity acquired from a human bite that was reconstructed using a 3-stage posterior auricular tubed flap. Helical rim avulsions may be ideally reconstructed with a tubed flap created from lax postauricular soft tissue. During the third stage, division and inset of the inferior pedicle of the flap were complicated by venous congestion. The use of leech therapy and topical nitroglycerin successfully improved flap circulation. Given the occurrence of venous congestion due to a sudden change in flap blood circulation, the authors propose a pedicle compression device to be used in the future that assists with flap conditioning. This physiological delay helps minimize flap ischemia by allowing choke vessels to dilate within, thus increasing flap reliability. Therefore, when the pedicle is divided, improved circulation from the previously inset superior pedicle has been established with a decreased risk of venous congestion and arterial insufficiency.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Partial-auricle reconstruction using tubed postauricular flap technique.
Why This Matters for Hirudotherapy
This case report describes partial auricular reconstruction after a human bite using a 3-stage posterior auricular tubed flap. During the third stage, venous congestion developed and was successfully managed with leech therapy combined with topical nitroglycerin, improving flap circulation. This directly documents a clinical application of leech therapy for venous congestion in a surgical flap, representing a relevant use case within the domain of hirudotherapy. However, as a single case report, it provides limited generalizable evidence, offers no quantitative outcome data isolating the leech therapy component, and cannot separate the contribution of leeching from the concurrent use of topical nitroglycerin.
Citation
Partial reconstruction of the auricle with the tubed postauricular flap: a case report.
Shteynberg et al. · The Journal of craniofacial surgery, 2024
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