Leeches help save woman's ear after dog mauling

Leeches help save woman's ear after dog mauling
Leeches help save woman's ear after dog mauling

HealthDay News -- A 19-year-old patient, who had her left ear ripped from her head during a pit bull attack, has regained full function and appearance of the ear after healthcare providers used leeches in the replantation procedure.

Stephen Sullivan, MD, MPH, an assistant professor of plastic surgery at Brown University in Providence, R.I., and Helena Taylor, MD, PhD, reported the case in the New England Journal of Medicine.

After preserving the ear, the surgical team started with a reconnection of a 0.3 millimeter-thick arterial branch, but because doctors couldn't immediately reconnect the veins, the patient was at high risk for congestion. So the doctors decided to try an experimental use for leeches, placing the organisms onto the side of the woman's head.

"They suck and drain away the blood, so more fresh blood can finally get in. And they do it quite efficiently. And while they're at it, it gives the body the time to make its own new veins, which is something that the body can do very efficiently as well. So the goal is to use the leeches as a temporary drainage system, until the patient can regenerate their own drainage system," Sullivan told HealthDay.

He described the entire process as "touch and go," noting that this is not a commonly performed procedure.

"The U.S. Food and Drug Administration approved leeches in 2004 for all sorts of amputation situations, with a detached finger probably being the most common type of scenario. But still, I would say that it's been done less than 50 times around the world."

After 17 days the leeches were finally removed, and the patient's own ear was surgically reattached. The result: a full recovery of the ear's function and appearance.

"Her hearing was totally unaffected by this," Sullivan said. "So I would say this is a perfect example of bio-inspiration, in which we take an organic talent and apply it successfully."

Sam Marzo, MD, an ear expert and the medical director of the Hearing and Balance Center at the Loyola University Health System, in Oakbrook Terrace, Ill., said that leech intervention is "not necessarily conventional, but useful."

"[F]or this whole thing to work you do have to have enough blood supply present," he said. "If the tissue is already dead and there's already no viable blood supply, then leeches won't work. But when used properly, and for the right reason, this can certainly work," Marzo said.

References

  1. Sullivan SR, Taylor HO. N Engl J Med. 2014; 370:1541.
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