Microsurgical ear replantation is venous repair necessary? A systematic review

作者：Momeni Arash^*; Liu Xiangxia; Januszyk Michael; Wan Derrick C; Buncke Gregory M; Buntic Rudolf F; Parrett Brian M

来源：Microsurgery, 2016, 36(4): 345-350.

DOI：10.1002/micr.22411

BackgroundA common postoperative observation after microsurgical ear replantation has been venous congestion necessitating alternate modes of decongestion, frequently in conjunction with blood transfusion. A comprehensive literature search was performed to assess the relationship between mode of vascular reconstruction and postoperative outcome as well as postoperative transfusion requirement after microsurgical ear replantation.
MethodsThe search was limited to cases of microsurgical ear replantation following complete amputation. Only articles published in English and indexed in PubMed were included.
ResultsThe initial search retrieved 285 articles, which was narrowed down to 40 articles reporting on 60 cases that matched the aforementioned criteria. Reconstruction of the arterial and venous limb (Group 1) was performed in 63.3% of patients and artery-only anastomosis (Group 2) was performed in 31.7%. Among measurable outcomes, only the duration of surgery was significantly different between groups (2.6 hours longer in Group 1 than Group 2; P=0.0042).
ConclusionIn light of contemporary data demonstrating successful artery-only ear replantation, replantation should not be abandoned when unable to establish venous outflow microsurgically.

• 出版日期2016-5