Successful auricle replantation via microvascular anastomosis 10 h after complete avulsion

Objective-To report a case of successful total auricle replantation 10 h after complete amputation. Material and Methods-Replantation was achieved by means of microvascular anastomosis and other therapies, and assisted by careful nursing. The patient's auricle was completely cut off with a sharp blade by an assailant, who retained it for 5 h. Having been retrieved, it was then preserved in ice for 5 h. Using microscopy, an artery and vein were found at the confluences of the upper and middle and lower and middle parts of the amputated auricle and head wound, respectively. An end-to-end anastomosis was performed on these vessels. After operation, the following treatments were used: drainage; reopening of the drainage channels with a needle; flushing or soaking with heparin sodium solution; controlling infection and coagulation; increasing blood volume; dilating vessels; and special nursing. Results-The replanted auricle survived with a normal contour and a very favorable esthetic appearance. Conclusions-The neat, uncontaminated wound margins and the fact that the amputated auricle was preserved in ice, even though it had been amputated 10 h before the operation, were prerequisites for successful auricle replantation. The microvascular anastomosis technique played a very important role in the survival of the amputated auricle. The postoperative treatment, observation and nursing were difficult but vital aspects of the procedure. The establishment of an effective venous return was a sign of the survival of the amputated auricle.