Artery-Only Ear Replantation in a Child: A Case Report With Daily Photographic Documentation
Case report published in Eplasty (2016)
Abstract
Objective: Ear replantation poses a significant technical challenge even for the skilled microsurgeon. Many ear amputations result from avulsion and thus have damaged and often diminutive vessels with a paucity of veins. Artery-only replantation is an option for ear salvage, but little is published on the clinical course and appearance after this procedure. Methods: A subtotal ear replantation was performed on a 10-year-old boy without a venous anastomosis. Leech therapy was used to manage venous congestion postoperatively, and daily photography was performed to document the clinical course. Results: Postoperative venous congestion was successfully managed with leech therapy. Four days after the replantation, arterial thrombosis occurred that required a take back and salvage with an interposition vein graft for arterial repair. Native venous drainage and arterial revascularization from skin edges were evident by postoperative day 12, and leeches were discontinued on day 14. The patient required debridement of the posterior ear and superior helix necrotic skin, with burying of the upper portion of the ear in a superior auricular skin flap. The ear was subsequently released from the head, and the exposed portions were covered successfully with a full-thickness skin graft. Conclusions: While arterial and venous anastomoses should always be attempted, arterial-only ear replantation can provide excellent results when venous congestion is properly managed. Daily photography can be a useful tool to monitor subtle skin color changes that may indicate native venous drainage and arterial revascularization.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Subtotal ear replantation in a 10-year-old boy without venous anastomosis; venous congestion managed with leech therapy for 14 days. Native venous drainage and arterial revascularization from skin edges established by postoperative day 12.
Por qué esto importa para la hirudoterapia
Este reporte de caso describe a un niño de 10 años que fue sometido a reimplante subtotal de la oreja sin anastomosis venosa tras una amputación, con congestión venosa postoperatoria manejada mediante terapia con sanguijuelas durante aproximadamente 14 días. Ocurrió trombosis arterial en el día 4 que requirió rescate con un injerto venoso de interposición, y el drenaje venoso nativo se hizo evidente hacia el día 12. El paciente finalmente requirió desbridamiento de piel necrótica y un injerto de espesor total, pero alcanzó un resultado exitoso. Para la ASH, esto es directamente relevante, ya que documenta el uso de la hirudoterapia para manejar la congestión venosa en un reimplante solo arterial, un escenario microquirúrgico desafiante. La salvedad es que se trata de un reporte de caso único sin datos control o comparativos, y el curso clínico involucró múltiples intervenciones, por lo que la contribución específica de la terapia con sanguijuelas al resultado final no puede aislarse.
Citación
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026