Using an unconventional perfusion pattern in ear replantation - arterialization of the venous system
Case report published in Microsurgery (2014)
Abstract
Ear amputation is a devastating injury characterized by a conspicuous deformity that is not easily concealed and can result in tremendous psychological trauma in addition to the physical insult. While numerous different approaches have been proposed, microvascular replantation is widely considered to deliver the best esthetic outcome. In this article, the authors report a case in which an unconventional perfusion pattern (i.e., arterialization of the venous system) was chosen, as intraoperative anatomic conditions precluded conventional vascular reconstruction. A 25-year-old male patient sustained a human bite resulting in subtotal amputation of his left ear. In the setting of an adequate arterial donor vessel, that is, branch of the posterior auricular artery, and a single suitable recipient vein (0.4 mm), the decision was made to perform an end-to-end arterio-venous anastomosis without the use of vein grafts. Medicinal leeches were applied postoperatively to provide for venous drainage. The ear survived and the patient was discharged after 14 days. To the best of our knowledge, this is first case of a subtotal ear amputation that was successfully replanted by arterialization of the venous system without the use of vein grafts and with preservation of the superficial temporal vessels.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
First reported case of subtotal ear amputation successfully replanted by arterialization of the venous system, using arterio-venous anastomosis and postoperative medicinal-leech therapy for venous drainage.
Por qué esto importa para la hirudoterapia
Este reporte de caso describe la amputación subtotal de la oreja izquierda por mordedura humana en un varón de 25 años, manejada con arterialización no convencional del sistema venoso mediante anastomosis arteriovenosa término-terminal utilizando una rama de la arteria auricular posterior y una vena receptora de 0,4 mm. Se aplicaron sanguijuelas medicinales en el posoperatorio para proporcionar drenaje venoso, y la oreja sobrevivió con alta hospitalaria a los 14 días. Para el ámbito de ASH, esto ilustra la terapia con sanguijuelas medicinales como un coadyuvante posoperatorio práctico en la reimplantación microquirúrgica cuando la reconstrucción venosa convencional no es factible. Advertencia: se trata de un reporte de caso único con una estrategia de reconstrucción vascular inhabitual, lo que limita la generalizabilidad; no aporta datos cuantitativos sobre la duración ni las complicaciones de la terapia con sanguijuelas.
Citación
Using an unconventional perfusion pattern in ear replantation - arterialization of the venous system.
Momeni A et al. · Microsurgery, 2014
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026