Successful replantation of an amputated helical rim with microvascular anastomosis
Case report published in Arch Craniofac Surg (2018)
Abstract
Replantation using microvascular anastomosis is considered to be the optimal method in treating the amputated ear in terms of resulting color, texture, and shape. Only a few cases of ear replantation have been reported because it is anatomically difficult to identify suitable vessels for anastomosis. We successfully replanted the amputated helical rim of the ear using single arterial anastomosis. A 37-year-old man had his helical rim amputated by a human bite. The amputee was about 4 × 1 cm in dimension, composed of skin and soft tissue including auricular cartilage. Replantation was performed anastomosing a small artery of the amputee with a terminal branch of the posterior auricular artery. After replantation, intravenous heparinization was performed and prostaglandin E1 and aspirin were administered. Venous congestion was decompressed by stab incisions applied with heparin solution soaked gauze. Venous congestion of the amputee slowly began to resolve at 4 days after the operation. The amputated segment of the helical rim survived completely with good aesthetic shape and color. The authors propose that performing microvascular anastomosis should be attempted especially if it is possible to detect vessels on cut surfaces of ear amputee and stump. Proper postoperative care for venous congestion, arterial insufficiency, and infection should be followed for amputee survival.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
A 37-year-old man's human-bite amputated helical rim was replanted with a single arterial anastomosis; venous congestion was decompressed by stab incisions with heparin-soaked gauze, and the segment survived completely with good aesthetic shape and color.
Context
This case report describes successful replantation of an amputated helical rim in a 37-year-old man using single arterial anastomosis of a small artery with a terminal branch of the posterior auricular artery. Postoperatively, venous congestion was managed with intravenous heparinization, prostaglandin E1, aspirin, and heparin solution-soaked gauze applied to stab incisions. The abstract makes no mention of leeches, hirudotherapy, or the leech secretome. This is a single case report documenting one surgical approach to ear replantation and its postoperative management.
Citation
Reference (Vancouver style)
Seo BF, Choi HJ, Lee MC, Jung SN. Successful replantation of an amputated helical rim with microvascular anastomosis. Arch Craniofac Surg. 2018;19(4):304-308. doi:10.7181/acfs.2018.02173. PMID: 30613096
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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