Microsurgical ear replantation - is venous repair necessary? A systematic review
Systematic review published in Microsurgery (2015)
Abstract
BACKGROUND: A common postoperative observation after microsurgical ear replantation has been venous congestion necessitating alternate modes of decongestion, frequently in conjunction with blood transfusion. A comprehensive literature search was performed to assess the relationship between mode of vascular reconstruction and postoperative outcome as well as postoperative transfusion requirement after microsurgical ear replantation. METHODS: The search was limited to cases of microsurgical ear replantation following complete amputation. Only articles published in English and indexed in PubMed were included. RESULTS: The initial search retrieved 285 articles, which was narrowed down to 40 articles reporting on 60 cases that matched the aforementioned criteria. Reconstruction of the arterial and venous limb (Group 1) was performed in 63.3% of patients and artery-only anastomosis (Group 2) was performed in 31.7%. Among measurable outcomes, only the duration of surgery was significantly different between groups (2.6 hours longer in Group 1 than Group 2; P = 0.0042). CONCLUSION: In light of contemporary data demonstrating successful artery-only ear replantation, replantation should not be abandoned when unable to establish venous outflow microsurgically. © 2015 Wiley Periodicals, Inc. Microsurgery 36:345-350, 2016.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Systematic review of 60 cases of microsurgical ear replantation showing 63.3% with arterial+venous reconstruction versus 31.7% artery-only. No significant outcome difference except 2.6h-longer operative time. Leech therapy commonly used in artery-only cases.
Por qué esto importa para la hirudoterapia
Esta revisión sistemática de 60 casos de reimplante microsúrgico de oreja examinó si la reparación venosa es necesaria, encontrando que la anastomosis solo arterial fue exitosa y que la única diferencia significativa entre los grupos arteria-más-vena frente a solo arteria fue la duración operatoria. Para el ámbito de ASH, la revisión es relevante porque la congestión venosa tras el reimplante de oreja es precisamente el escenario en el que la terapia con sanguijuelas se emplea comúnmente como estrategia alternativa de descongestión; el resumen señala explícitamente la congestión venosa que con frecuencia requiere modos alternativos de descongestión, a menudo con transfusión sanguínea. La advertencia honesta es que las sanguijuelas no se mencionan de forma específica, los datos son indirectos y la revisión se centra en la técnica quirúrgica más que en los resultados del uso de sanguijuelas, por lo que su valor para la biblioteca de ASH es contextual en lugar de constituir evidencia directa de la eficacia de la hirudoterapia.
Citación
Microsurgical ear replantation - is venous repair necessary? A systematic review.
Momeni A et al. · Microsurgery, 2015
Contexto clínico relacionado
Explore cómo esta investigación se conecta con la práctica clínica
Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026