Joseph Upton
American · Surgery
American surgeon whose 1987 reports in Plastic and Reconstructive Surgery documented medicinal leeches salvaging a microsurgically reattached ear threatened by venous thrombosis.
Profile
- Nationality
- American
- Era
- Late 20th century
- Primary field
- Surgery
Institutional Affiliations
- Boston Children's Hospital (Division of Plastic and Oral Surgery)
- Beth Israel Deaconess Medical Center (Department of Surgery, Division of Plastic Surgery)
- Harvard Medical School (faculty)
- American Society for Surgery of the Hand
Key Contributions
- Co-author, with Mutimer and Banis, of the 1987 report in Plastic and Reconstructive Surgery presenting three cases of microsurgical reattachment of totally amputated ears — an uncomplicated success, a salvage of an impending failure and a late failure due to venous thrombosis (PMID 3823244).
- Documented the technical obstacles of ear reattachment: avulsed vessels of 0.3 to 0.7 mm diameter, difficulty identifying vessels and distinguishing arteries from veins, and demanding venous anastomoses, with vein grafts necessary in two of the three patients and anticoagulation essential in alleviating venous thrombosis (PMID 3823244).
- Reported the use of medicinal leeches (Hirudo medicinalis) to salvage one ear reattachment complicated by venous thrombosis (PMID 3823244).
- Sole author of the 1987 article 'Leeches' in Plastic and Reconstructive Surgery (PMID 3809288).
Importance to Hirudotherapy
Joseph Upton is an American surgeon whose published work of 1987 addressed the surgical management of totally amputated ears. Writing with Mutimer and Banis in Plastic and Reconstructive Surgery, he presented three clinical cases spanning the outcomes of that era: an uncomplicated success, a salvage of an impending failure, and a late failure due to venous thrombosis (PMID 3823244). The report set out the obstacles particular to ear reattachment — avulsed vessels of 0.3 to 0.7 mm diameter, difficulty identifying vessels and distinguishing arteries from veins, and the demands of venous anastomoses; vein grafts were necessary in two of the three patients, and anticoagulation was found essential in alleviating venous thrombosis. When venous thrombosis compromised one reattached ear, medicinal leeches (Hirudo medicinalis) were used to salvage the case, and the authors concluded that successful microvascular reattachment of an amputated ear is superior to any other means of reattachment or reconstruction (PMID 3823244). Upton also published an article entitled 'Leeches' in the same journal that year (PMID 3809288). ASH's statements about his institutional appointments and about the widely reported 1985 Boston ear-reattachment case remain subject to ongoing source verification and are not asserted here.
Key Publications
- Leeches · Plastic and Reconstructive Surgery (1987) · PMID 3809288
- Microsurgical reattachment of totally amputated ears · Plastic and Reconstructive Surgery (1987) · PMID 3823244
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