American Society of Hirudotherapy

Posttraumatic lip replantation in a pregnant woman

Case report published in Plastic and Reconstructive Surgery Global Open (2022)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical LiteratureSafety & Infection ControlCaragher SP et al. · Plastic and reconstructive surgery. Global open, 2022

Abstract

Traumatic lip amputation is a devastating injury. No other tissue replicates its unique histology, often limiting the reconstructive outcome. Replantation is a technically challenging procedure, requiring extensive postoperative optimization, including systemic anticoagulation, leech therapy, significant blood loss, and antibiosis. Given the rarity of replantation in the context of pregnancy, there are no documented accounts of lip replantation in pregnant patients. We report a case of a 25-year-old pregnant woman who sustained an avulsion injury of the right upper lip from a dog bite. The patient presented with the amputated lip and emergent microvascular replantation was performed. Postoperative course consisted of management of controlled yet significant blood loss through leech therapy and close collaboration with obstetric colleagues. The patient was ultimately discharged with successful cosmetic and functional outcome and, importantly, with maintenance of a healthy pregnancy.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article

Summary

A 25-year-old pregnant woman underwent emergency microvascular replantation after a dog bite avulsed her right upper lip. Postoperative care included leech therapy for controlled yet significant blood loss and close obstetric collaboration, resulting in a healthy pregnancy and successful cosmetic and functional outcome.

Why This Matters for Hirudotherapy

This case report details the emergent microvascular replantation of an avulsed upper lip in a 25-year-old pregnant woman following a dog bite. Postoperative management included leech therapy, described in the context of managing controlled yet significant blood loss, alongside close collaboration with obstetric colleagues. The patient was discharged with a successful cosmetic and functional outcome and maintenance of a healthy pregnancy. This is a single case report involving a unique clinical situation (pregnancy).

Citation

Reference (Vancouver style)

Caragher SP, Hwang CD, Gardenier JC, Khouri KS, Buta MR, McCarty JC, et al. Posttraumatic lip replantation in a pregnant woman. Plast Reconstr Surg Glob Open. 2022;10(11):e4662. doi:10.1097/GOX.0000000000004662. PMID: 36415621

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.