Replantation of the Avulsed Pinna: 100 Percent Survival with a Single Arterial Anastomosis and Substitution of Leeches for a Venous Anastomosis

Leech Therapy for Patients With Surgically Unsalvageable Venous Obstruction After Revascularized Free Tissue Transfer

“…At the time of initial tissue transfer, the use of leeches when no venous anastomosis is possible has rarely been reported for free flaps, but it is well established for digit, 24 auricle, 25,26 nose, 27 and lip 28 replantation. Leech therapy used for salvaging head and neck free flaps that would otherwise require another major reconstruction is not as well described.…”

Mixed Arterio-Venous Insufficiency in Random Skin Flaps in the Rat: Is the Application of Medicinal Leeches Beneficial?

“…By ingesting blood volumes of 20-60ml each (9,27,38), leeches provide efficient venous decompression, and thereby maintain the capillary microcirculation until the process of neovascularization has established new venous connections for drainage (39). This has been confirmed by clinical reports of the successful use of leeches for the salvage of pedicled (28,40,41) and free "axial" flaps (38,42,43), as well as in severe venous congestion of replanted digits (32,33) and ears (26,31).…”

Microsurgical Replantation of a Totally Amputated Ear Without Venous Repair

“…[8][9][10][11][12][13][14] In one of the reported cases 8 postoperative heparinization was not used. Despite this, the transfusion of 3 units of blood was necessary.…”