Lip replantation: A viable option for lower lip reconstruction after human bites, a literature review and proposed management algorithm

Liliav, Benjamin; Zaluzec, Rebekah M; Hassid, Victor Joseph; Ramasastry, Sai S.; Kalimuthu, Ramasamy

doi:10.1016/j.bjps.2012.01.003

Cited by 9 publications

(3 citation statements)

References 3 publications

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“…Lesions in humans either are allowed to heal by second intention, repaired via primary closure, or reconstructed via a myriad of flap and grafting techniques. If sufficient tissue and viable blood vessels are available, microvascular surgery to repair torn neurovascular bundles is the preferred therapy ( 6 , 20 , 21 ). This option gives the patient the highest chance at regaining function and sensation ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation, Causes, Treatment, and Outcome of Lip Avulsion Injuries in Dogs and Cats: 24 Cases (2001–2017)

Saverino

Reiter

2018

Front. Vet. Sci.

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Lip avulsions are a common result of orofacial trauma in dogs and cats. Vehicular trauma and bite wounds are common causes. Surgical therapy is highly successful with early decontamination and tension-free closure. This retrospective case series assessed the signalment, causes, lesion location, treatment and outcome of lip avulsion injuries in dogs and cats. A total of 23 patients with 24 lip avulsion injuries were included in the study. They were comprised of 11 dogs and 12 cats. The patients were generally young, with 68.2% under 3 years of age and 36.4% under 1 year of age. The most common known causes were animal bites (26.1%) and vehicular trauma (21.7%). In cats, the most common cause was vehicular trauma (25%). In dogs, the most common cause was an animal bite (45.4%). Bilateral rostral upper lip avulsion was most common in dogs (36.3%), whereas bilateral rostral lower lip avulsion was most common in cats (53.8%). Concurrent injuries were frequent in both species with tooth fractures reported in 34.7%. All lip avulsion injuries were treated via wound debridement and lavage followed by appositional repair with absorbable suture material. The most common short-term complication was wound dehiscence (21.4%). Surgical therapy was highly successful with no significant long-term complications reported. The results suggest that lip avulsion injuries are primarily seen in younger dogs and cats, usually result from vehicular trauma or animal bites, and are successfully managed with surgical repair.

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Section: Discussionmentioning

confidence: 99%

Clinical Presentation, Causes, Treatment, and Outcome of Lip Avulsion Injuries in Dogs and Cats: 24 Cases (2001–2017)

Saverino

Reiter

2018

Front. Vet. Sci.

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“…This can be corrected by later using an Abbe´ flap to reconstruct the central vermillion without moving the commissure. Larger defects or those involving other areas of the lip can be repaired using similar lip-switch procedures or a variety of local flaps ( 40 - 43 ).…”

Section: Discussionmentioning

confidence: 99%

Experience with Aesthetic Reconstruction of Complex Facial Soft Tissue Trauma; Application of the Pulsed Dye Laser

2014

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Background:Facial soft tissue injury can be one of the most challenging cases presenting to the plastic surgeon. The life quality and self-esteem of the patients with facial injury may be compromised temporarily or permanently. Immediate reconstruction of most defects leads to better restoration of form and function as well as early rehabilitation.Objectives:The aim of this study was to present our experience in management of facial soft tissue injuries from different causes.Patients and Methods:We prospectively studied patients treated by plastic surgeons from 2010 to 2012 suffering from different types of blunt or sharp (penetrating) facial soft tissue injuries to the different areas of the face. All soft tissue injuries were treated primarily. Photography from all patients before, during, and after surgical reconstruction was performed and the results were collected. We used early pulsed dye laser (PDL) post-operatively.Results:In our study, 63 patients including 18 (28.5%) women and 45 (71.5%) men aged 8-70 years (mean 47 years) underwent facial reconstruction due to soft tissue trauma in different parts of the face. Sharp wounds were seen in 15 (23%) patients and blunt trauma lacerations were seen in 52 (77%) patients. Overall, 65% of facial injuries were repaired primary and the remainder were reconstructed with local flaps or skin graft from adjacent tissues. Postoperative PDL therapy done two weeks following surgery for all scars yielded good results in our cases.Conclusions:Analysis of the injury including location, size, and depth of penetration as well as presence of associated injuries can aid in the formulation of a proper surgical plan. We recommend PDL in the early post operation period (two weeks) after suture removal for better aesthetic results.

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“…In the specific case of lip amputation, microsurgical replantation has the potential for superior aesthetic outcomes as well as restoration of sensory and motor function. Since James reported successful microsurgical replantation of the lip in 1976, there have only been 21 cases reported, four of which were due to human bites [1][2][3][4][5][6]. Due to the paucity of reports on this, complications are likely to be underreported.…”

Section: Introductionmentioning

confidence: 99%

Complications of Microvascular Upper Lip and Free Grafted Nasal and Eyebrow Replantation After Assault via Human Bite

Leach¹,

Lundberg²,

Holcombe³

2019

Cureus

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Amputation of facial soft tissue, particularly avulsion due to human bite, is an uncommon injury that has severe cosmetic and functional implications. Microsurgical replantation has the potential for superior aesthetic outcomes and restoration of function. We report a case of a 46-year-old male who sustained avulsion injuries from human bites, which included portions of his eyebrow, nose, and upper lip. Artery and vein microvascular replantation was performed on the upper lip. The amputated eyebrow and nasal segments were replanted in a similar fashion to a skin graft. On post-operation day 1, our patient suffered an ischemic stroke followed by a myocardial infarction requiring systemic tissue plasminogen activator (tPA) treatment. Following administration of tPA, there was continuous bloody discharge from the replant sites and the eyebrow, nose, and upper lip began to appear increasingly dusky. Our patient was determined to be a high-risk candidate for immediate revision surgery and he subsequently underwent a six-stage secondary reconstruction. At his most recent four-month follow-up, our patient is satisfied with his cosmetic and functional outcomes. This was a case of failed microvascular upper lip replantation and eyebrow and nasal replacement complicated by stroke and myocardial infarction. The authors review the common complications in replantation, particularly pertaining to upper lip reanastamosis, and discuss a potential novel complication encountered in this case relevant to both free graft and microvascular replantation.

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Lip replantation: A viable option for lower lip reconstruction after human bites, a literature review and proposed management algorithm

Cited by 9 publications

References 3 publications

Clinical Presentation, Causes, Treatment, and Outcome of Lip Avulsion Injuries in Dogs and Cats: 24 Cases (2001–2017)

Clinical Presentation, Causes, Treatment, and Outcome of Lip Avulsion Injuries in Dogs and Cats: 24 Cases (2001–2017)

Experience with Aesthetic Reconstruction of Complex Facial Soft Tissue Trauma; Application of the Pulsed Dye Laser

Complications of Microvascular Upper Lip and Free Grafted Nasal and Eyebrow Replantation After Assault via Human Bite

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