Atypical replantation and reconstruction of frozen ear: A case report
Dvořák Z, Stupka I (2020) · Medicine (Baltimore) · n=1
Detalle de evidencia de RCTReferencia del ensayo
Perfil del estudio
- Diseño
- single-patient case report (38-year-old man, occupational ear avulsion transported on dry ice, St. Anne's University Hospital Brno, Czech Republic)
- Tamaño de la muestra (n)
- 1
- Intervención
- Replantation of frozen ear (transported on dry ice) with arterial and venous anastomosis; postoperative venous congestion managed with leech therapy
- Comparador
- Conventional replantation of fresh amputated ear
- Punto final primario
- Ear replantation feasibility from frozen state with leech adjunct
- Resultado primario
- Successful replantation despite frozen storage; venous congestion at 9 hours managed with leech therapy; freezing cold injury required radix/proximal helix reconstruction with conchal cartilage graft wrapped in subauricular flap
- Duración del seguimiento
- Postoperative reconstruction phase
- PMID
- 32443314
Hallazgos clave
- First reported successful frozen ear replantation
- Dry ice transport of amputated ear
- Venous congestion at 9 hours postoperatively managed with leeches
- Freezing cold injury required staged reconstruction
- Satisfactory final aesthetic outcome
Limitaciones
- Single case - extreme storage condition not generalizable
- Inevitable freezing tissue damage limits outcomes
- Cannot quantify leech contribution to overall salvage
- Long-term cosmetic outcomes limited
- Storage conditions unique to specific occupational setting
Implicaciones clínicas
Dvořák 2020 expands the boundary of acceptable amputated ear storage conditions to include frozen state with dry ice transport. For US clinicians under K040187, the case demonstrates leech therapy's role as enabling technology in pushing surgical boundaries - here, salvaging an ear that would otherwise be deemed non-viable due to freezing.
Estudios relacionados
Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature
Akhoondinasab MR, Farahmand HR, Zahedi A, Saraee A (2023)
Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy
Banihani OI, Fox JA, Gander BH, Grunwaldt LJ, Cannon GM (2014)
Leeches and Caudal Analgesia After Replantation for Glans Amputation During Neonatal Circumcision
Mousa A, Keefe DT, Wong K, Davidge K, Lorenzo AJ, Dos Santos J (2022)
Penile Replantation: A Review of Microsurgical Techniques, Patient Outcomes, and Solutions to Complex Reconstructive Challenges
Arbel EJ, Reese AD, Richards R, Singh S, O'Shea AW, Hennig F, Abramowitz D (2024)