Replantation of a lip thrown in the bin
Case report published in Journal of Stomatology, Oral and Maxillofacial Surgery (2021)
Abstract
Management of soft tissue avulsion after facial bites could be challenging in some situation. We presented the case of a 32 years old men suffering from a full thickness avulsion of the left lower lip and cheek after a dog bite. Even if the lip fragment was initially put on the bin, a microvascular replantation was performed. The vascularization was based on the left inferior labial artery. No veins were found. We used post-operative leech therapy to avoid venous congestion during 10 days. A large antibiotherapy was conducted. Adaptation of antibiotics blood concentration was also necessary due to the permanent bleeding caused by leech therapy. At the 6 month consultation, the patient recovered an impressive labial function and sensibility. Replantation gives the best functional and esthetical outcomes in these rare and complex cases. Artificial blood drainage, large antibiotic therapy and close post-operative follow-up are significant parts of the replantation success.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
32-year-old man with dog-bite avulsion of left lower lip and cheek (lip fragment initially discarded). Microvascular replantation on left inferior labial artery without venous anastomosis; 10-day leech therapy with antibiotic-titration produced excellent labial function and sensibility at 6 months.
Why This Matters for Hirudotherapy
This case report describes the microvascular replantation of a full-thickness avulsed lower lip and cheek in a 32-year-old man following a dog bite, where no recipient veins could be found. To prevent venous congestion, medicinal leech therapy was utilized for ten days postoperatively, requiring adapted antibiotic management to account for the permanent bleeding caused by the leeches. This case is highly relevant to hirudotherapy, effectively demonstrating the use of leeches as a temporary venous outflow substitute in complex plastic surgery. The primary limitation is that it is a single case report, which also serves to highlight the known clinical necessity of carefully monitoring and adjusting for blood loss when utilizing leech therapy.
Citation
Replantation of a lip thrown in the bin.
Galmard L et al. · Journal of stomatology, oral and maxillofacial surgery, 2021
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