The efficacy of arterial only microsurgical nasal replantation: a systematic review
Systematic review published in ANZ J Surg (2024)
Abstract
BACKGROUND: Microsurgical nasal replantation is a rare yet important procedure in order to regain the respiratory, olfactory, and aesthetic features of the nose. However, due to the traumatic nature of most nasal amputations, appropriate veins for anastomosis are difficult to find- complicating replantation. This is the first systematic review that compares peri operative and post-operative outcomes in arterial only versus arterial and venous anastomosis for nasal replantation. METHODS: A comprehensive search of Medline, SCOPUS, and Embase databases up to 30th November 2023 was undertaken. Inclusion criteria included studies reporting on nasal replantation. Reports were then split into venous anastomosis and arterial only anastomosis and compared against one another. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports tool was used for bias assessment. Comparative analysis was undertaken using Microsoft Excel software utilizing chi squared tests and t-tests where necessary. RESULTS: A total of 27 papers with a sample size of 29 were found. Risk of bias for the included studies was generally low. Demographics between the two groups were similar. Arterial only anastomosis was on average 2 h and 32 min faster. Arterial only anastomosis utilized Hirudotherapy (medicinal leeching) more often than venous anastomosis (P = 0.01) whereas venous anastomosis used heparin more frequently (P = 0.01). Otherwise, complications, tissue preservation, hospital stay and follow up outcomes were similar between the two groups. CONCLUSION: The evidence to date suggests that arterial only anastomosis is a safe and viable method for nasal replantation.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Systematic review of 27 papers (29 patients) comparing arterial-only versus arterial-plus-venous anastomosis in microsurgical nasal replantation. Arterial-only anastomosis used hirudotherapy significantly more often (p=0.01) than venous anastomosis.
Por qué esto importa para la hirudoterapia
Esta revisión sistemática compara los desenlaces perioperatorios y postoperatorios de la anastomosis solo arterial frente a la anastomosis arterial y venosa para la reimplantación nasal microquirúrgica a lo largo de 27 artículos con un total de 29 casos, encontrando que la anastomosis solo arterial fue, en promedio, 2 horas y 32 minutos más rápida y utilizó hirudoterapia (sanguijuelismo medicinal) con mayor frecuencia que la anastomosis venosa (P=0,01), mientras que la anastomosis venosa utilizó heparina con mayor frecuencia (P=0,01), con complicaciones, preservación tisular, estancia hospitalaria y desenlaces de seguimiento por lo demás similares. La revisión concluye que la anastomosis solo arterial es un método seguro y viable para la reimplantación nasal. Para el dominio de la ASH, esto es relevante, ya que documenta el uso de la hirudoterapia en la reimplantación nasal; sin embargo, el resumen no caracteriza la terapia con sanguijuelas como estándar, no valida su eficacia ni especifica su papel clínico preciso más allá del uso diferencial entre los grupos.
Citación
The efficacy of arterial only microsurgical nasal replantation: a systematic review.
Secanho MS et al. · ANZ journal of surgery, 2024
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026