Microvascular replantation of a composite facial avulsion in a 24 ‐month‐old child after dog bite

We report a case of a 24‐month‐old female who sustained a large composite facial avulsion injury from a pit bull dog bite. The avulsed tissue involved a substantial portion of the patient's mid‐face, including the entire soft tissue of the nose, upper lip, part of the left cheek, and left oral commissure. Artery‐only microvascular replantation was performed because no recipient vein could be identified from the facial defect. Medicinal leech therapy was used for eight days postoperatively to prevent venous congestion. The patient experienced significant blood loss due to leech therapy and required nearly 29 L of blood product replacement. At the last follow up of 8 months postoperatively, the patient was recovering well with significant improvement in function and cosmesis of the mid‐face. This case describes a successful artery‐only replantation of an avulsive bite injury to the face of a young child. Despite the technical difficulty of cases such as this one, microvascular replantation should be attempted because when successful it provides a superior cosmetic and functional result to other reconstructive techniques.
Source: Microsurgery - Category: Surgery Authors: Tags: CASE REPORT Source Type: research