Total lower lip and chin replantation following a trampoline accident: Rescue surgery with intensive leech therapy
Case report published in Journal of stomatology, oral and maxillofacial surgery (2026)
Abstract
Lip amputations in children may require urgent microsurgical management. Here we report a salvage procedure with partial survival following lower lip and chin replantation after a trampoline accident. Total amputation was managed with inferior labial artery anastomosis; however, venous drainage was not reestablished, necessitating leech therapy. Despite arterial revisions, 75 % of the lip and 25 % of the chin were lost by post-operative day 14. Reconstruction with a combined right Karapandzic flap and left Camille Bernard flap was performed one month later, supplemented by mesotherapy and nanofat injections. The outcome was marked by residual microstomia. These injuries are rare in children, often caused by dog bites. Venous anastomosis is frequently unfeasible, with leech therapy critical for drainage. When replantation is partially successful, reconstruction may involve local flaps or free tissue transfers. Microsurgical expertise, access to leech therapy and close collaboration with intensivists are essential for optimizing outcomes.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Lip amputations in children may require urgent microsurgical management.
Why This Matters for Hirudotherapy
This case report describes a salvage procedure for total lower lip and chin replantation in a child following a trampoline accident, where inferior labial artery anastomosis was performed but venous drainage was not reestablished, necessitating leech therapy. Despite arterial revisions and leech therapy, 75% of the lip and 25% of the chin were lost by post-operative day 14, requiring subsequent reconstruction with local flaps and resulting in residual microstomia. The abstract states that venous anastomosis is frequently unfeasible in such injuries, with leech therapy described as critical for drainage, and identifies access to leech therapy among essentials for optimizing outcomes. Caveat: this is a single case report documenting real-world use of leech therapy in facial replantation salvage, with partial tissue loss despite intervention and no control group.
Citation
Total lower lip and chin replantation following a trampoline accident: Rescue surgery with intensive leech therapy
Sounthakith V et al. · Journal of stomatology, oral and maxillofacial surgery, 2026
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