title: Microsurgical ear replantation-is venous repair necessary?-A systematic review.
abstract: BACKGROUND
  A common postoperative observation after microsurgical ear replantation has been venous congestion necessitating alternate modes of decongestion, frequently in conjunction with blood transfusion. A comprehensive literature search was performed to assess the relationship between mode of vascular reconstruction and postoperative outcome as well as postoperative transfusion requirement after microsurgical ear replantation.
  
  
  METHODS
  The search was limited to cases of microsurgical ear replantation following complete amputation. Only articles published in English and indexed in PubMed were included.
  
  
  RESULTS
  The initial search retrieved 285 articles, which was narrowed down to 40 articles reporting on 60 cases that matched the aforementioned criteria. Reconstruction of the arterial and venous limb (Group 1) was performed in 63.3% of patients and artery-only anastomosis (Group 2) was performed in 31.7%. Among measurable outcomes, only the duration of surgery was significantly different between groups (2.6 hours longer in Group 1 than Group 2; P = 0.0042).
  
  
  CONCLUSIONS
  In light of contemporary data demonstrating successful artery-only ear replantation, replantation should not be abandoned when unable to establish venous outflow microsurgically. © 2015 Wiley Periodicals, Inc. Microsurgery 36:345-350, 2016.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.
authors.forename: Xiangxia
authors.initials: X
authors.lastname: Liu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Januszyk
authors.affiliation: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.
authors.forename: Derrick C
authors.initials: DC
authors.lastname: Wan
authors.affiliation: California Pacific Medical Center, The Buncke Clinic, Division of Microsurgery, San Francisco, CA.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Buncke
authors.affiliation: California Pacific Medical Center, The Buncke Clinic, Division of Microsurgery, San Francisco, CA.
authors.forename: Rudolf F
authors.initials: RF
authors.lastname: Buntic
authors.affiliation: California Pacific Medical Center, The Buncke Clinic, Division of Microsurgery, San Francisco, CA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Parrett
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery*; D001158:Arteries / Q000601:surgery*; D004431:Ear, External / Q000098:blood supply / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D012092:Replantation / Q000379:methods*; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery*