Chinese surgeons become first to graft patient’s ear onto her foot after accident

Chinese surgeons have performed the world’s first operation to graft a patient’s torn-off ear onto her foot before putting it back in place.\nThe woman’s ear was torn off in a workplace accident in April that also ripped away a large part of her scalp, medical news platform Med-J reported on Monday.\nQiu Shenqiang, deputy director of the microsurgery unit at Shandong Provincial Hospital in Jinan, said the woman’s injuries had been caused by heavy machinery and left her with life-threatening injuries.\nThe scalp, neck and facial skin had been torn and “split into multiple fragments” while the ear had been “completely severed along with the scalp”.\nWhen the woman arrived at the hospital, its hand, foot and reconstructive microsurgery team immediately tried to repair the scalp using standard methods.\nBut the severe damage the accident had caused to her scalp tissue and vascular network meant that this approach failed.\nThis meant that the team were unable to reattach the ear until the skull tissue had healed, forcing the team to look for ways to keep the ear alive until it was ready to be reattached.\nQiu’s team ultimately decided to graft the ear onto the top of her foot before undertaking a months-long process of recovery and reconstruction.\nThe surgeon said that they had made this decision because the arteries and veins in the foot were of a suitable calibre and highly compatible with those of the ear.\nIts skin and soft tissue are also of a similar thinness to those found on the head, requiring minimal adjustment after the transplant.\nThis highly complex procedure had no precedent or documented successful cases to draw upon.\nThe initial step of grafting the ear onto the foot took 10 hours, according to the report. One challenge lay in the ear’s exceptionally fine blood vessels, measuring merely 0.2–0.3mm in diameter, which required a high degree of skill and extensive microsurgery experience to connect them together, Qiu said.\nFive days after the operation, the team encountered another critical situation when problems with the circulation of blood to the heart, a condition known as venous reflux, obstructed the supply to the ear, turning it a purplish-black colour.\nTo save it, the team had to resort to the laborious technique of manual bloodletting, which required around 500 applications over five days.\nMeanwhile, the team restored the patient’s scalp by grafting skin taken from her stomach onto her head.\n\n\nMore than five months later, after the transplanted scalp and neck skin had healed, the swelling had subsided and the surgical sites on the ear and foot had fully closed, the medical team were able to put the ear back in place.\nIn October, the team led by Qiu successfully performed this six-hour procedure, setting a global precedent.\nThe patient, identified only by the surname Sun, has now left hospital and her face and tissue function have now largely recovered.\nShe still faces a few more relatively minor operations, including restoring her missing eyebrows and reducing scarring on the foot.\n