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The Scientific World Journal
Volume 2014 (2014), Article ID 105234, 6 pages
http://dx.doi.org/10.1155/2014/105234
Clinical Study

Use of the Mechanical Leech for Successful Zone I Replantation

Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 271 Chenbo-ro, Uijeongbu-si, Gyeonggi-do 480-717, Republic of Korea

Received 13 September 2013; Accepted 28 January 2014; Published 23 March 2014

Academic Editors: J. U. Carmona, G. J. Hooper, and W. R. Walsh

Copyright © 2014 Sang Wha Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Replantation of zone I finger injuries remains a challenge, particularly if the fingertip was previously scarred or atrophied, which makes it difficult to secure a suitable vein at the amputation site. In cases of artery-only anastomosis, we propose using a mechanical leech technique to maintain sufficient venous outflow until the internal circulation regenerates. We applied this procedure to eight patients who had zone 1 amputations without veins that were suitable for anastomosis. Emergent surgery was performed and an artery-only anastomosis was created. As there were no veins available, we cut a branch of the central artery and anastomosed it with a 24-gauge angioneedle, which served as a conduit for venous drainage. The overall survival rate for zone I replantation using mechanical leech was 87.5% and the average time to maintain the mechanical leech was 5 days. The mechanical leech technique may serve as an alternative option for the management of venous congestion when no viable veins are available.