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Doctors Combine Modern Microsurgery And Ancient Leeching To Save Ear

September 25, 1985 GMT

BOSTON (AP) _ Doctors who reattached a boy’s severed ear with microsurgery feared the operation might fail when drugs didn’t overcome a complication, so they turned to one of their profession’s oldest tools: leeches.

″It wouldn’t have worked if we hadn’t been able to use the leeches,″ said Dr. Joseph Upton, who headed the team of Children’s Hospital surgeons that operated on Guy Condelli, 5, of Medford, who had been attacked by a dog.

Reattachments of severed ears are rarely successful because the ear’s blood vessels are exceptionally tiny - so small they can’t be seen with the naked eye. The only reported success was five years ago in Australia, Upton said.


When Guy and his severed ear were rushed to Upton after the attack Aug. 16, ″I decided to give it a try, even though the success rate is almost nil.″

Members of the surgical team worked for 12 hours under microscopes that magnified by 40 times the torn veins and arteries they had to reconnect. The operation worked, and blood flowed through the reattached vessels.

But Guy’s recovery was complicated by poor circulation. Although blood flowed into the ear, clots formed in the veins so it could not return to the heart. Three days after the operation, the ear turned blackish blue with congested blood.

At first, doctors gave the child heparin, a medicine that prevents clotting, and made cuts in the ear to let out blood. However, the child was losing a lot of blood, and doctors feared the operation would fail.

As a surgeon in Vietnam, Upton had sometimes used leeches to heal wounds, and he decided they were worth a try.

″I started calling around the country to my friends trying to find some hungry leeches,″ Upton said. He eventually found a variety of medical leeches, known as Hirudo medicinalis, in England and had some flown to Boston.

He attached two of the 11/2 -inch-long worms to the child’s ear. They slowly filled with blood and eventually became 8 inches long and looked something like fat cigars.

Besides sucking blood, the leeches inject an anesthetic and anticoagulant into the flesh to keep blood from clotting.

″The ear perked up right away,″ Upton said. ″It was obvious it was going to work.″

The doctors continued the therapy for a week and used up about two dozen leeches. By that time, normal circulation was restored in the child’s healthy- looking reattached ear.

The boy’s mother, Darlene, said Tuesday she had no doubts about the leeches. ″I said, ‘If it works, do it. Whatever it takes.’ He put the leeches on, and it was incredible how much better it looked.″

Guy was discharged from the hospital about two weeks after the operation and is going to kindergarten. ″His ear looks terrific,″ Mrs. Condelli said.

Upton said leeches were occasionally used for finger reattachments in France but are rarely used in the United States.

Dr. Richard Wolfe, a medical historian at Harvard, said leeches have been used since ancient times to draw bad blood from wounds, but they fell from favor in the mid-1800s.

The child did not seem to mind the leeches and could not feel them, said Upton. And the tedious surgery and difficult recovery were far better than the alternative of losing the ear.