This case report describes a superb result following the delayed replantation (after eight hours) of the distal right nostril following a dog bite. The patient was a heavy smoker. Two arteries and two veins were anastomosed, one measuring 0.6mm and the others 0.5mm. The amputated segment survived completely and no further intervention was required... “Chapeaux!” It seems heartless to criticise this magnificent achievement, BUT... the authors describe testing the patency of the anastomoses by employing the “Ackland test” (sic). There is no description of this test in the article and no reference to it in the bibliography. Robert Acland described a test for patency in microscopic vessels, using microsurgical forceps to gently occlude the vessel proximal to the anastomosis, emptying the vessel by stroking it and then releasing the proximal forceps. A successful test showed blood flowing past the suture line. It is only fair to that trail blazer for microvascular surgery to acknowledge his contributions and those editors who missed this rather obvious error should be brought to book!
Successful nose replantation
Reviewed by Martyn Webster
Successful delayed nose replantation following a dogbite: arterial and venous microanastomosis using interpositional vein grafts.
