Joseph Upton

Importancia para la hirudoterapia

Joseph Upton is an American surgeon whose published work of 1987 addressed the surgical management of totally amputated ears. Writing with Mutimer and Banis in Plastic and Reconstructive Surgery, he presented three clinical cases spanning the outcomes of that era: an uncomplicated success, a salvage of an impending failure, and a late failure due to venous thrombosis (PMID 3823244). The report set out the obstacles particular to ear reattachment — avulsed vessels of 0.3 to 0.7 mm diameter, difficulty identifying vessels and distinguishing arteries from veins, and the demands of venous anastomoses; vein grafts were necessary in two of the three patients, and anticoagulation was found essential in alleviating venous thrombosis. When venous thrombosis compromised one reattached ear, medicinal leeches (Hirudo medicinalis) were used to salvage the case, and the authors concluded that successful microvascular reattachment of an amputated ear is superior to any other means of reattachment or reconstruction (PMID 3823244). Upton also published an article entitled 'Leeches' in the same journal that year (PMID 3809288). ASH's statements about his institutional appointments and about the widely reported 1985 Boston ear-reattachment case remain subject to ongoing source verification and are not asserted here.