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Published on: February 24, 2016
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Partial salvage of avulsed tissue after dog bite
J S Øregaard1, C L Lang1, A Venzo1
1Rigshospitalet, Copenhagen , Denmark.
Annals of the Royal College of Surgeons of England
|December 18, 2015
Summary
Severe facial dog bites can be treated with microsurgical tissue replantation. This case highlights successful functional and cosmetic recovery after complex nasal reconstruction, even with initial complications like venous congestion and skin necrosis.
Area of Science:
- Reconstructive Surgery
- Microsurgery
- Trauma Management
Background:
- Facial trauma, particularly dog bites, poses significant functional and cosmetic challenges.
- Nasal injuries can lead to severe aesthetic and breathing impairments.
- Microsurgical techniques offer potential solutions for complex tissue avulsions.
Observation:
- An 18-year-old female sustained a dog bite to the central face, resulting in nasal tissue avulsion.
- Initial replantation involved microsurgical arterial anastomosis; venous anastomosis was not feasible.
- Venous congestion was managed with leech therapy, followed by skin necrosis and revision surgery.
Findings:
- Revision surgery revealed healthy tissue, enabling coverage with a full-thickness skin graft.
- At eight months post-operation, the patient exhibited satisfactory functional and cosmetic outcomes.
- This case demonstrates a rare instance of successful healing for a severe nasal injury.
Implications:
- Microsurgical replantation is a viable option for severe nasal avulsions, even with initial setbacks.
- Leech therapy can be an adjunct in managing venous congestion during reconstructive procedures.
- Successful outcomes in severe facial trauma underscore the importance of advanced surgical techniques and patient selection.
