Successful microsurgical lip replantation: monitoring venous congestion by blood glucose measurements in the replanted lip
Case report published in JPRAS Open (2017)
Abstract
Replantation of an amputated lip using microvascular anastomosis is the best option for restoration of the defect. However, the amputated region often lacks veins with appropriate diameters for microvascular anastomoses and typically necessitates both postoperative exsanguination using medicinal leeches and a blood transfusion. We present a case of the successful replantation of an avulsed lip in which postoperative congestion was evaluated objectively by measuring blood glucose levels in the replanted region. The patient presented to our hospital with an upper lip avulsion that was caused by a dog bite. The lip was replanted by the microvascular anastomoses of one artery and two veins using interposed vein grafts. The replanted lip showed signs of congestion on postoperative day one; exsanguination using medicinal leeches was attempted, while blood glucose levels were measured every three hours. Critical congestion, which did not occur in this patient, was defined as a blood glucose level lower than 40 mg/dL. Lip replantation was successful without any complications in this patient.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Novel use of intra-flap blood-glucose measurements to objectively monitor venous congestion during leech therapy in a replanted upper lip; threshold <40 mg/dL defined as critical congestion.
Por qué esto importa para la hirudoterapia
This case report presents the successful microsurgical replantation of an upper lip avulsed by a dog bite, where postoperative congestion was evaluated objectively by measuring blood glucose levels in the replanted tissue. Medicinal leeches were used for exsanguination while blood glucose levels were monitored every three hours to detect critical congestion, defined as below 40 mg/dL (which did not occur in this patient). The lip replantation was ultimately successful without complications. The article relates to hirudotherapy by documenting leech-based exsanguination as part of postoperative management in lip replantation, alongside an objective glucose-based monitoring protocol. However, the evidence is strictly limited to a single case report and provides no comparative data on leeching versus other drainage methods.
Citación
Successful microsurgical lip replantation: monitoring venous congestion by blood glucose measurements in the replanted lip.
Tachi K et al. · JPRAS Open, 2017
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026