Amputation trauma of the face: surgical techniques and microsurgical replantations

Abstract

The reconstruction of facial parts after traumatic amputation is of special interest because of the psychological and functional implications such accidents have on the patient. Most amputations result from dog bites or knife wounds and are often sustained by children and young adults. The amputated part may be an anatomic structure of functional importance (e.g. , the lips) or a static structure of primarily aesthetic importance (e.g. , the ear or nose). Here, the Authors present results in 6 cases of facial amputation reconstructed using microsurgical replantation for upper lip amputation, with use of the facial artery musculomucosal flap to fill labial defects, and the Mladick method for ear replantation.

Keywords: Dog bite; Face; Lip; Microvascular replantation; Traumatic amputation.

Fig. 1

Case 1. A 2-year-old girl: amputation of three-quarters of the mid lower lip in a fall.

Fig. 2

Case 1. FAMM flap harvesting.

Fig. 3

Case 1. Immediate post-operative view.

Fig. 4

Case 1. 1-year follow-up.

Fig. 5

Case 1. 4-year follow-up.

Fig. 6

Case 2. A 32-year-old female with partial amputation of upper lip resulting from dog bite; defect comprising vermilion and philtrum.

Fig. 7

Case 2. Immediate post-operative view.

Fig. 8

Case 2. Leech therapy.

Fig. 9

Case 2. 3-year follow-up.

Fig. 10

Case 3. A 19-year-old male with upper-third of ear amputated by dog bite.

Fig. 11

Case 3. View following cartilage reattachment.

Fig. 12

Case 3. Mladick retro-auricular pocket method. Immediate post-operative view.

Fig. 13

Case 3. 18-month follow-up.

Fig. 14

Case 3. 18-month follow-up: ear details.