Microsurgical replantation and salvage procedures in traumatic ear amputation
Retrospective case series published in J Trauma (2010)
Abstract
PURPOSE: The purpose of this study is to present our experience with patients who underwent traumatic ear amputation. METHODS: Between January 1988 and April 2002, 10 patients sustained ear amputations. Of these, six patients underwent microvascular replantation (arterial anastomosis only and arterial and venous anastomosis in three patients each), and replantation was attempted in one patient. However, no suitable vessel could be found for the anastomosis, and the amputated ear was treated as a composite graft and buried in a retroauricular pocket. Staged costal cartilage reconstruction was performed in three patients who lost the ear replant after trauma (two patients) or due to infection (one patient). RESULTS: The ear replant survived and showed good cosmetic results in the three patients who underwent arterial and venous anastomoses. The patients who had artery anastomosis only required intrareplant heparin injection (chemical leech) to resolve venous congestion and sustained partial loss of the replanted ear. Secondary procedures were necessary to repair the reconstructions, including an advancement, temporoparietal fascia, or retroauricular flap. Those who underwent staged ear reconstruction had late ear deformities. CONCLUSION: Microvascular replantation is the best method for reattaching an amputated ear, giving excellent esthetic results. If only arterial anastomosis is performed, a chemical leech is an option for decompressing the venous congestion. In those patients without a suitable vessel for microanastomosis, nonmicrosurgical methods are suggested, such as a temporoparietal fascia flap, retroauricular pocket procedure, or staged-costal cartilage reconstruction, depending on the ear defect.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Of 10 ear amputations between 1988–2002, 6 underwent microvascular replantation. Patients with arterial-only anastomosis required intrareplant heparin injection (chemical leech) but sustained partial loss of the replanted ear.
Por qué esto importa para la hirudoterapia
Este reporte describe a 10 pacientes con amputaciones traumáticas del pabellón auricular tratados entre 1988 y 2002, de los cuales seis fueron sometidos a reimplante microvascular. Tres pacientes con anastomosis solo arterial requirieron inyección de heparina intraimplante («sanguijuela química») para abordar la congestión venosa, pero todos sufrieron pérdida parcial del oído reimplantado. Para el ámbito de ASH, este estudio solo es relevante de forma indirecta, ya que describe una alternativa farmacológica a las sanguijuelas medicinales en lugar de la terapia con sanguijuelas propiamente dicha. El concepto de «sanguijuela química» es paralelo al objetivo terapéutico de la hirudoterapia real —descomprimir la congestión venosa—, pero utiliza inyección de heparina en el tejido reimplantado en lugar de anticoagulantes derivados de sanguijuelas. La advertencia es que este estudio no involucra sanguijuelas reales y el enfoque de «sanguijuela química» produjo pérdidas parciales, lo que imposibilita comparar con los resultados de las sanguijuelas medicinales únicamente a partir de estos datos.
Citación
Microsurgical replantation and salvage procedures in traumatic ear amputation.
Lin PY et al. · The Journal of trauma, 2010
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026