Total lower lip and chin replantation following a trampoline accident: Rescue surgery with intensive leech therapy

Study Profile

Design

single pediatric case report of total lower lip and chin replantation following a trampoline accident requiring rescue microsurgical management with arterial-only inferior labial artery anastomosis and intensive medicinal leech therapy in the absence of venous anastomosis (Department of Maxillofacial Surgery and Plastic Surgery, Necker - Enfants Malades Hospital AP-HP, Paris Cite University, Paris, France)

Sample size (n)

1

Intervention

Inferior labial artery anastomosis with intensive medicinal leech therapy as the primary venous drainage strategy in the absence of successful venous anastomosis; arterial revisions performed but venous drainage not reestablished; supplemental local-flap reconstruction (Karapandzic and Camille Bernard flaps) plus mesotherapy and nanofat injections performed one month later

Comparator

Not applicable - single-patient pediatric case report; comparison to alternative replantation strategies is narrative only

Primary endpoint

Survival of the replanted lip and chin segments and residual functional/cosmetic outcome

Primary result

Partial survival was achieved despite intensive leech therapy and arterial revisions: 75% of the replanted lip and 25% of the replanted chin were lost by postoperative day 14; subsequent reconstruction with combined Karapandzic and Camille Bernard local flaps plus mesotherapy and nanofat injections was performed at one month; outcome was marked by residual microstomia; authors emphasize the critical role of leech therapy in this arterial-only pediatric replantation scenario and the essential collaboration with intensivists, pharmacy, and pediatric anesthesia

Follow-up duration

minimum 1-month follow-up plus subsequent staged reconstruction

PMID

41513071