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Acute nasal reconstruction with forehead flap after dog bite
Andrew H Huang1, Michael S Wong
1From the Division of Plastic Surgery, University of California Davis Medical Center, Sacramento, CA.
Annals of Plastic Surgery
|March 15, 2013
Summary
Immediate nasal reconstruction using forehead flaps is effective for severe dog bite injuries where nasal segments are lost. This method offers a reliable solution for disfiguring facial trauma, though cartilage grafting may be needed later.
Area of Science:
- Plastic Surgery
- Facial Reconstruction
- Trauma Surgery
Background:
- Dog bites frequently cause nasal injuries, avulsing aesthetic subunits and complicating primary repair.
- Previous treatments like microsurgical replantation assume salvageable nasal segments, which is often not the case after animal attacks.
Observation:
- This study details two cases of significant nasal injury from dog bites with loss of multiple aesthetic subunits.
- Avulsed nasal portions were not recovered, necessitating immediate reconstruction.
Findings:
- Acute forehead flaps were employed for immediate, first-stage nasal reconstruction in full-thickness defects.
- Skin and nasal lining were reconstructed acutely; cartilage grafts were deferred due to contamination concerns, leading to some vestibule collapse addressed later.
Implications:
- Forehead flap reconstruction is a reliable technique for immediate repair of dog bite-induced nasal defects, even with extensive tissue loss.
- Further research is needed to determine the role of acute cartilage grafting in improving long-term outcomes for these challenging injuries.