[China Tech] Medical Miracle: Surgeons Reattach Severed Ear After 20 Hours Via Innovative Foot Implant Technique

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After an extraordinary 20 hours of ischemia, a medical team at Shanghai Ninth People's Hospital successfully saved and replanted a patient's completely severed ear in a groundbreaking microsurgical breakthrough.

The surgeons overcame long-standing clinical restrictions and maintained an ear that was previously thought to be nearly irreparable by using a novel two-stage strategy of dorsal foot temporary vascular nurturing and subsequent orthotopic replantation.

On June 11, the patient was involved in an accident that resulted in a full traumatic tear of the right ear. The patient came to Shanghai Ninth People's Hospital with a severed ear.

The detached ear had experienced 20 hours of ischemia by the time surgical preparations were finished, significantly longer than the typical 6-8 hour golden window for ear replantation. The chances of tissue necrosis and surgical failure are greatly increased by such prolonged ischemia.

An even more significant challenge was identified by additional preoperative evaluation: The superficial temporal arteries and veins at the initial lesion location were totally burst and obliterated, leaving no functioning local vasculature for rapid replantation.

Because forceful vessel connection would probably result in embolism and complete ear necrosis, traditional vascular anastomosis was therefore not viable.

Tissue assessment revealed viable and well-preserved tissue despite the incredibly lengthy ischemia time, enabling salvage restoration.

The emergency microsurgery team, under the direction of Dr Wang Tingliang, came up with an inventive tiered repair plan to get around the limitations of traditional procedures.

The severed ear was implanted onto the patient's dorsal foot to temporarily restore blood circulation. Microsurgeons created a dependable temporary perfusion system and chose appropriate branch vessels on the foot.

A dual venous return channel that significantly increased surgical stability and safety was created by carefully anastomosing two sets of micro veins, each measuring between 0.2 and 0.5 millimeters in diameter, at the upper and lower segments of the ear with corresponding foot veins.

The ear was securely fixed in place to complete the first round of vascular nurturing.

Over the following nine days, the team conducted intensive 24-hour monitoring of the ear's color, temperature and capillary circulation. Consistent and stable perfusion with no congestion or necrotic changes verified full recovery of tissue viability, satisfying all criteria for secondary replantation.

On June 22, the second-stage operation was performed to relocate the ear back to its original anatomic position. Multiple accurate microvascular connections were completed to restore complete arterial inflow and venous outflow.

The patient recovered smoothly after surgery, without infection, a vascular crisis, or other complications. After the surgery, follow-up checks showed that blood was flowing well and the area was healing properly, which means the patient successfully got through the risky part of the microsurgery.

As of June 29, the replanted ear has survived with a satisfactory appearance and normal physiological function. The patient is expected to be discharged soon, the hospital said.

Dr Wang noted that such an extreme and prolonged ischemia replantation case is clinically rare worldwide. This innovative foot-nurturing staged technique effectively resolves the dual challenges of long-duration ischemia and local vascular damage, maximizing the restoration of both cosmetic aesthetics and physiological function of the severed ear.