Replantation of Nearly Total Nose Amputation without Venous Anastomosis

Microsurgical replantation and postoperative leech treatment of a large severed nasal segment

“…During the past three decades some papers have been published describing nasal replantation with no possibility of recreating a venous anastomosisall of which had a satisfying functional and aesthetic outcome [1][2][3][4].…”

“…These vary from simple reattachment or replacement of the severed piece, to microsurgical replantation, and finally primary or secondary reconstruction with composite grafts or local flaps. Replantation is, when successful, superior to other reconstructive methods [1]. This case report describes a microsurgical replantation of a large nasal segment with a good functional and cosmetic result.…”

Supermicrosurgical replantation of a small amputated nasal tissue in a child

“…'s successful case, exploration and anastomosis of one artery and one vein of approximately 0.6 mm took a total operating time of under 3 h. The anesthetic time for this case was <2 h, illustrating that replantation can be performed within a reasonable duration . Many similar cases reported in the literature have consistently reported success in replanting nasal subunits with only arterial repair , suggesting the need to survey for available artery only and hence obviating the need for time spent looking for vein.…”

“…There is a general belief that composite grafting of traumatically amputated nasal tissue has poor outcome [1,2]; however, related publications are few. A Pubmed search of the keywords "nasal amputation" or "nose amputation" yielded only 22 articles in the English literature related to either composite grafting [3][4][5][6][7][8][9][10] or microvascular replant [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] of amputated nasal segments. In the seven articles related to composite grafting, a total of 12 cases are reported.…”

A case of paediatric nasal avulsion replanted using microsurgery

“…5 To date, eight cases of traumatic isolated nasal avulsions treated with this technique have been reported. 3,4,[6][7][8][9][11][12][13] In four of these cases, 7-9,11 venous outflow could not be reconstructed for the replanted segment, as in our case. All previous cases described the use of artery-to-artery anastomosis to provide the inflow of arterial blood to the replant.…”