Arterial only anastomosis associated with modified Baudet technique in ear replantation: Case reports and literature review
Case reports published in Medicine (Baltimore) (2021)
Abstract
BACKGROUND: Total ear amputation is a relatively rare trauma with an absolute indication for surgical treatment. Numerous techniques for auricular reconstruction have been described. When local and general conditions allow microsurgical replantation, this must be the first choice. We propose the association of microsurgical techniques with some modification (modified Baudet technique) to obtain higher survival rate of the reimplanted stump. METHODS: This study included cases of 3 male patients with total ear amputation, the injuries and their mechanism (workplace accident) being identical. Chief complaints were pain, bleeding, important emotional impact due by an unaesthetic appearance. The established diagnosis was traumatic complete ear amputation (grade IV auricular injury according to Weerda classification). Microsurgical replantation was performed only with arteriorraphy, and no vein anastomosis. Cartilage incisions and skin excisions were made to enlarge the cartilage-recipient site contact area. Medicinal leeches were used to treat venous congestion, to which systemic anticoagulant therapy was added. RESULTS: The results showed the survival of the entire replanted segment in all cases, with good function and esthetical appearance. Patients were fully satisfied with the final outcome. CONCLUSION: Microsurgical replantation is the gold standard, for the surgical treatment of total ear amputation. We believe that cartilage incisions and the increased surface of contact between cartilage and recipient site has an adjuvant role in revascularization of the amputated stump (with only arterial anastomosis) and the use of hirudotherapy helps to relieve early venous congestion.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Three male workplace-accident patients with total ear amputation underwent microsurgical replantation with only arteriorraphy plus modified Baudet cartilage/skin technique; medicinal leeches relieved venous congestion in all cases with full segment survival.
Почему это важно для гирудотерапии
This case report describes three male patients with total traumatic ear amputations who underwent microsurgical replantation using a modified Baudet technique with arterial-only anastomosis. Medicinal leeches and systemic anticoagulant therapy were used to manage venous congestion, and all replanted ear segments survived with good functional and aesthetic outcomes. The authors conclude that hirudotherapy helps relieve early venous congestion in this setting. This study provides direct, albeit small-scale, clinical evidence supporting the use of medicinal leech therapy in complex ear replantation surgery, making it relevant to ASH's domain. However, the evidence is limited to three case reports, and the comparative contribution of leeching versus surgical modifications and systemic anticoagulation is not isolated.
Цитирование
Arterial only anastomosis associated with modified Baudet technique in ear replantation: Case reports and literature review.
Pertea M et al. · Medicine (Baltimore), 2021
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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