Non-microvascular Successful Management of Near-total Ear Avulsion

Traumatic ear avulsion represents a difficult challenge for all reconstructive surgeons; hence, replantation and reattachment will provide the best aesthetic outcome. However, when microsurgery is not possible, the surgeon must choose the most appropriate alternative method to address the concern. We are reporting a case of a near-total right ear external auricle amputation attached only by small skin bridge. The patient was admitted to our institute 22 hours after sustaining an injury during a motor vehicle collision. He was successfully managed by reattaching the external auricle into the anatomical place, with the repair of cartilage. This was followed by applying a daily protocol for venous congestion with the use of subcutaneous and intradermal injection of low-molecular-weight heparin daily for 10 days with gradual tapering of the dose. The external auricle survived with no complications or morbidity. Subcutaneous and intradermal low-molecular-weight heparin can be used effectively in cases of severe venous congestion of avulsed ear with adequate arterial inflow without causing any morbidity.