Partial salvage of avulsed tissue after dog bite
Øregaard JS, Lang CL, Venzo A (2015) · Annals of the Royal College of Surgeons of England · n=1
Study Profile
- Design
- single-patient case report (18-year-old woman, central facial dog bite injury, Rigshospitalet Copenhagen)
- Sample size (n)
- 1
- Intervention
- Microsurgical arterial anastomosis for nasal tip replantation with leech therapy when venous anastomosis impossible; skin necrosis subsequently managed with revision and full-thickness skin graft
- Comparator
- No control - case report
- Primary endpoint
- Nasal tissue salvage and aesthetic outcome after dog bite avulsion
- Primary result
- Partial nasal salvage achieved through arterial-only anastomosis with leech therapy; subsequent skin necrosis required revision with full-thickness skin graft; satisfactory cosmetic and functional result at 8-month follow-up
- Follow-up duration
- 8 months postoperative
- PMID
- 26673050
Key Findings
- Facial dog bite avulsion salvage with arterial-only anastomosis + leech
- Subsequent skin necrosis required revision
- Healthy tissue immediately below necrotic skin enabled FTSG closure
- Satisfactory 8-month aesthetic outcome
- Demonstrates leech utility in facial reconstruction context
Limitations
- Single case - limited generalizability
- Partial necrosis suggests leech alone insufficient
- 8-month follow-up may not capture long-term outcomes
- Subjective cosmetic assessment
- Cannot quantify leech contribution to partial salvage
Clinical Implications
Øregaard 2015 documents leech therapy's role in facial dog-bite avulsion salvage. For US clinicians under K040187, the case demonstrates the device's utility in facial trauma beyond ear replantation - specifically, when arterial-only anastomosis is necessary because no suitable veins are available for primary anastomosis. The eventual need for FTSG revision shows leech therapy is not a panacea.
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