Trovato Matthew J, Agarwal Jayant P
California Pacific Medical Center-The Buncke Clinic, San Francisco, California, USA.
Ann Plast Surg. 2008 Aug;61(2):164-8. doi: 10.1097/01.sap.0000185457.53295.2f.
Successful microvascular ear replantation is well described, and often involves the use of arterial inflow anastomoses with leeches and systemic anticoagulation to augment outflow. Failed replantation attempts have also been published, with most of the failures attributed to venous drainage problems. A case of successful replantation of an ear is presented using a single 0.5-mm arteriovenous anastomosis, as no suitable artery could be identified in the amputated part. Postoperatively, dextran and leech therapies were employed to promote adequate venous drainage. We report a 100% successful ear replantation using a single arterialized vein as the inflow. In situations where no adequate artery is identifiable in the amputated part, an arteriovenous anastomosis may be a suitable alternative.
成功的耳部微血管再植已有详细描述,通常需要使用水蛭进行动脉流入吻合术并进行全身抗凝以增加流出。也有关于再植失败尝试的报道,大多数失败归因于静脉引流问题。本文介绍了一例耳部成功再植的病例,由于在断离部分无法找到合适的动脉,故采用单一0.5毫米动静脉吻合术。术后,使用右旋糖酐和水蛭疗法促进充分的静脉引流。我们报告了使用单一动脉化静脉作为流入血管实现100%耳部再植成功的案例。在断离部分无法找到足够动脉的情况下,动静脉吻合术可能是一种合适的替代方法。