Use of the Mechanical Leech for Successful Zone I Replantation

Abstract EN

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.