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Microvascular Replantation Following Facial Dog Bites in Children: Systematic Review and Management Algorithm.

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Area of Science:

  • Plastic Surgery
  • Pediatric Surgery
  • Trauma Surgery

Background:

  • Pediatric dog bites are a significant public health concern, often requiring reconstructive surgery.
  • Microvascular replantation is considered for severe facial dog bite injuries in children.
  • This study systematically reviews microvascular replantation for pediatric facial dog bites.

Purpose of the Study:

  • To systematically review literature on microvascular replantation after pediatric facial dog bites.
  • To analyze perioperative morbidity and long-term follow-up in these cases.
  • To develop a management algorithm based on published experiences.

Main Methods:

  • Case review of microvascular replantation for pediatric facial dog bite injury.
  • Systematic literature search for similar reported cases.
  • Descriptive statistical analysis of collected clinical variables.

Main Results:

  • The youngest patient reported to date underwent replantation at our institution.
  • Nineteen additional cases (18 months to 17 years) were identified with long follow-up.
  • Venous congestion was common, requiring multimodal management; long-term outcomes were excellent with functional recovery, though revisions were frequent.

Conclusions:

  • Microvascular replantation is the definitive reconstructive option for pediatric facial dog bite amputations.
  • Consideration for microvascular exploration is warranted for extensive facial injuries.
  • Extensive parental counseling on morbidity is essential, but successful outcomes are achievable with meticulous care.