Refinements in Ear Replantation

James, SE; Re, Adlard; Da, Ross

doi:10.1097/01.prs.0000245335.80696.f6

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…First, the reexploration of small thrombosed veins in the edematous surgical field is unlikely to restore flow but will disrupt inosculation at the replant site. Second, ear replants have survived without surgically established or with failed venous outflow . Loss of arterial inflow 80 hours after replantation jeopardized the viability of the ear replant.…”

Section: Discussionmentioning

confidence: 99%

Microvascular salvage of a thrombosed total ear replant

Senchenkov

Jacobson

2013

Microsurgery

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Microvascular replantation, when possible, is the treatment of choice for total ear amputations. Both arterial and venous reconstruction should be attempted. The present case report describes a successful total ear replantation in a 45-year-old woman whose ear was amputated due to a horse accident. Venous thrombosis subsequently occurred and was managed with anticoagulation and leech therapy. Eighty hours after the replantation, arterial thrombosis took place. The posterior auricular artery thrombosed anastomosis was resected and reconstructed with an interposition vein graft. This report illustrates the feasibility of the successful microvascular salvage of a thrombosed total ear replant. It suggests the need for close clinical monitoring of the replanted ear and prompt microvascular reexploration in an event of the loss of arterial flow.

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Section: Discussionmentioning

confidence: 99%

Microvascular salvage of a thrombosed total ear replant

Senchenkov

Jacobson

2013

Microsurgery

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“…10,17,23,29–31 But it is also proposed as a primary alternative when microsurgical anastomosis is not feasible. 8,15,22,32–37…”

Section: Discussionmentioning

confidence: 99%

“…35 In any case, the general conditions of the patient must be taken into account, because leeching implies blood loss, which in some patients is better avoided. 32…”

Section: Discussionmentioning

confidence: 99%

Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature

Facchin

Lancerotto

Arnež

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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Background:Ear avulsion is a rare complication of different traumas, such as car accidents, human or animal bites and stab wounds, and can result in dramatic cosmetic consequences for the patient. Ear replantation, revascularization, and reattachment are the options offering best aesthetic results. But venous outflow insufficiency is responsible for a high rate of failures. Leeching is one the most efficient methods to relieve venous congestion. It has been used as an alternative venous outflow in case of severe impairment of the physiologic one.Methods:We present a case of successful rescue of a congested reattached ear by leeching after subtotal avulsion, along with a review of the literature on cases of avulsed auricle reconstruction salvaged by hirudotherapy. Data were collected and analyzed to identify a best regimen to deal with venous congestion.Results:More than 130 cases of avulsed auricle savage are described in the literature, in a fourth of which leech therapy was used in the management of venous congestion.Discussion:In case of both venous outflow deficit or absence, leeches are a potentially successful option to correct the congestion while new veins reestablish normal physiology. The need for anticoagulant/antiaggregant therapy, antibiotics, and often blood transfusion are the main pitfalls of leeching.Conclusion:Leeches can be considered a salvage method for ear replantation and reattachment in those cases that lack venous outflow in the presence of valid arterial inflow.

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“…A meaningful analysis of the methods of venous decongestion (including medicinal leech therapy and blood drainage through puncture wounds/small incisions), as well as postoperative anticoagulation regimen was not possible given the heterogeneous protocols employed and comparatively sparse datasets.…”

Section: Discussionmentioning

confidence: 99%

“…This finding confirms previous reports mentioning lack of a relationship between venous repair and transfusion requirement. 61 A meaningful analysis of the methods of venous decongestion (including medicinal leech therapy 5,9,13,14,[16][17][18]47,50,51,53,58,60,[62][63][64]68,72 and blood drainage through puncture wounds/small incisions 10,15,16,18,48,54,59,73 ), as well as postoperative anticoagulation regimen was not possible given the heterogeneous protocols employed and comparatively sparse datasets.…”

Section: Discussionmentioning

confidence: 99%