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.
Резюме
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.
Почему это важно для гирудотерапии
This report describes 10 patients with traumatic ear amputations managed between 1988 and 2002, of whom six underwent microvascular replantation. Three patients with artery-only anastomosis required intrareplant heparin injection ('chemical leech') to address venous congestion, but all sustained partial loss of the replanted ear. For ASH's domain, this study is only indirectly relevant, as it describes a pharmacological alternative to medicinal leeches rather than leech therapy itself. The concept of a 'chemical leech' parallels the therapeutic goal of actual hirudotherapy — decompressing venous congestion — but uses heparin injection into the replant tissue rather than leech-derived anticoagulants. The caveat is that this study involves no actual leeches and the 'chemical leech' approach yielded partial losses, making it impossible to compare against medicinal leech outcomes from this data alone.
Цитирование
Microsurgical replantation and salvage procedures in traumatic ear amputation.
Lin PY et al. · The Journal of trauma, 2010
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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