[Successful ear replantation without venous anastomosis by using leeches]

Replantation of the ear is a challenging problem for the reconstructive surgeon. Avulsion injury and intima tears of these small vessels often make back cuts and venous interposition necessary. Furthermore, identification and differentiation of the vessels are difficult. The volume of the ear is large in relation to the wound surface and the absence of axial venous outflow makes replantation prone to venous congestion. On the basis of a case report we present the problems, the specific management and final outcome of a successful ear replantation and we discuss the alternative possibilities of reconstruction.