Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature
Case report published in Plastic and Reconstructive Surgery Global Open (2018)
Abstract
BACKGROUND: Ear avulsion is a rare complication of different traumas, such as car accidents, human or animal bites and stab wounds, and can result in dramatic cosmetic consequences for the patient. Ear replantation, revascularization, and reattachment are the options offering best aesthetic results. But venous outflow insufficiency is responsible for a high rate of failures. Leeching is one the most efficient methods to relieve venous congestion. It has been used as an alternative venous outflow in case of severe impairment of the physiologic one. METHODS: We present a case of successful rescue of a congested reattached ear by leeching after subtotal avulsion, along with a review of the literature on cases of avulsed auricle reconstruction salvaged by hirudotherapy. Data were collected and analyzed to identify a best regimen to deal with venous congestion. RESULTS: More than 130 cases of avulsed auricle savage are described in the literature, in a fourth of which leech therapy was used in the management of venous congestion. DISCUSSION: In case of both venous outflow deficit or absence, leeches are a potentially successful option to correct the congestion while new veins reestablish normal physiology. The need for anticoagulant/antiaggregant therapy, antibiotics, and often blood transfusion are the main pitfalls of leeching. CONCLUSION: Leeches can be considered a salvage method for ear replantation and reattachment in those cases that lack venous outflow in the presence of valid arterial inflow.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Case of leech-mediated salvage of a congested reattached ear after subtotal avulsion with review of >130 published cases of auricle reconstruction salvage, identifying optimal leeching regimens.
Por qué esto importa para la hirudoterapia
Este artículo presenta un caso de rescate exitoso de una oreja reinsertada y congestionada mediante hirudoterapia tras una avulsión subtotal, acompañado de una revisión de la literatura que identifica más de 130 casos de rescate de pabellón auricular avulsionado, aproximadamente una cuarta parte de los cuales empleó hirudoterapia para el manejo de la congestión venosa. Los autores concluyen que las sanguijuelas pueden servir como método de rescate cuando el drenaje venoso está ausente o comprometido pero existe un flujo arterial entrante válido. Esto es directamente relevante para la hirudoterapia, ya que las sanguijuelas se describen como uno de los métodos más eficientes para aliviar la congestión venosa y una opción potencialmente exitosa mientras nuevas venas restablecen la fisiología normal. Los autores señalan que la necesidad de terapia anticoagulante/antiagregante, antibióticos y frecuentemente transfusión sanguínea son las principales desventajas de la hirudoterapia.
Citación
Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature.
Facchin F, Lancerotto L, Arnež ZM, Bassetto F, Vindigni V · Plastic and reconstructive surgery. Global open, 2018
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026