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Successful partial ear replantation after prolonged ischaemia time
O P Shelley1, O Villafane, S B Watson
1West of Scotland Regional Plastic Surgery Trauma and Burns Unit, Glasgow Royal Infirmary, Glasgow, UK.
British Journal of Plastic Surgery
|February 5, 2000
Summary
Successful ear replantation was achieved 33 hours post-amputation using heparin to promote blood flow, despite challenges like arterial spasm. This case suggests planned urgent management may be suitable for similar ear replantation scenarios.
Area of Science:
- Reconstructive Microsurgery
- Trauma Surgery
Background:
- Replantation of avulsed tissues, particularly the ear, presents unique challenges due to its limited vascular supply.
- Delayed replantation increases the risk of tissue necrosis, necessitating innovative management strategies.
Observation:
- A 34-year-old male underwent successful replantation of the upper pole of his pinna 33 hours after amputation.
- No venous anastomosis was performed; anticoagulation via systemic heparinization and local subcutaneous heparin injections was employed to facilitate venous outflow.
Findings:
- The replantation was successful, demonstrating the potential efficacy of anticoagulation in the absence of venous anastomosis.
- Complications encountered included arterial spasm and bleeding, which were managed conservatively.
Implications:
- This case highlights a potential alternative management approach for ear replantations, advocating for planned urgent rather than emergency treatment.
- The findings may inform future strategies for managing complex ear trauma and improving outcomes in delayed replantation cases.