Background: Total ear avulsion is one of the most serious auricular traumas. Its surgical procedure is complicated and involves high technical difficulty. The auricular blood vessels mostly contain capillaries, and capillary anastomosis reconstruction is difficult. Right ear vascular anastomosis and auricle replantation under microscope are very few cases of successful replantation of total ear avulsion. The lack of blood supply in the amputated ear leads to postoperative blood supply disturbance. At present, there are no reports on the application of hyperbaric oxygen therapy following the replantation of severed ears. Hyperbaric oxygen therapy was used to promote the recovery of vascular microcirculation, reduce complications and improve the survival rate of postoperative ear transplantation.
Case description: We present a rare case of total ear avulsion in a 53-year-old Chinese man. The patient complained of cutting injury of the right auricle for more than 1 hour. The patient had a history of hypertension for 4 years, and his blood pressure was well controlled by regular administration of valsartan. This paper reports on the treatment experience in a case of microscope-assisted auricular replantation, targeted postoperative treatment, early intervention with hyperbaric oxygen therapy, and individualized nursing care. After 16 days of careful treatment, the patient's avulsion ear survived and he was discharged from the hospital. After 6 months of continuous follow-up, the auricular shape and hearing of the patient reached the ideal standard.
Conclusions: Precise medical and nursing cooperation coupled with meticulous management of the patient throughout the entire process are key factors for the survival of the severed ear. The combined application of microscopic techniques and hyperbaric oxygen therapy improves blood circulation to the anastomosed vessels, accelerates the healing of the replanted ear, and shortens the length of hospital stay. Early hyperbaric oxygen treatment can make postoperative wound heal quickly. Early intervention of hyperbaric oxygen therapy after ear avulsion is helpful to the recovery of patients with ear avulsion. However, the initiation time and duration of intervention need to be further optimized and more evidence is needed to support it.
Keywords: Replant ear avulsion; case report; hyperbaric oxygen; total ear disconnect injury.
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