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A Mechanical Leech for Successful Zone I Replantation
Sang Wha Kim, MD1, Sung No Jung, MD, PhD1, Youn Hwan Kim, MD, PhD2
1Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Uijongbu, South Korea, 2Department of Plastic and Reconstructive Surgery, Hanyang University, Seoul, Korea

Replantation of zone I finger injury remains a challenge. Especially, previously injured finger tip is usually scarified or atrophied and it is difficult to secure suitable vein at the amputee. In cases of artery only anastomosis, we introduce the mechanical leech technique to maintain sufficient venous outflow until internal circulation reconstruct.

We applied this procedure to 3 patients who had zone 1 amputation without suitable vein. Emergent surgery was performed and the artery was anastomosed. As there were no veins available, we cut the branch of the cruciate anastomosis and anastomosed with 24-gauze angioneedle, which is utilized as venous drainage. All 3 digits were replanted successfully. By the use of mechanical leech, apposite venous drainage was feasible without incision to the amputee or usage of leech.

We introduce simple and easy mechanical leech technique using angioneedle, which is another option of the management of venous congestion when no other veins are available.

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