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Case Reports
. 2014 Sep 7:8:298.
doi: 10.1186/1752-1947-8-298.

An unexpected presentation of a traumatic wound on the lower lip: a case report

Jaume Miranda-Rius  1 , Lluís Brunet-Llobet, Eduard Lahor-Soler, Carlos Mendieta
Affiliations
Case Reports

An unexpected presentation of a traumatic wound on the lower lip: a case report

Jaume Miranda-Rius et al. J Med Case Rep. .

Abstract

Introduction: Traumatic lip injuries present major challenges in terms of reconstructive options and the outcome of surgical management. The aetiology of lip injuries includes human bite as interpersonal violence. Bite wounds are always considered to be complex injuries contaminated with unique polymicrobial inoculum. A classification of facial bite injuries has been included and the surgical management of these lesions has also been discussed. We report a rare bite injury on the lower lip that resembled an ulcerative process.

Case presentation: A 30-year-old African man presented with a severe tissue defect on his lower lip to a Dental and Oral Department in Tanzania. He explained that 12 days ago he had been involved in a fight and someone had bitten his lower lip. An orofacial examination confirmed a serious loss of lip tissue that resembled a chronic ulcerative process. Accurate assessment of the lesion was made by a thorough evaluation of some parameters such as size, depth, presence of granulation tissue, fibrin coverage, wound edges, exudates and/or necrosis. A surgical debridement under local anaesthesia was carried out. Afterwards a layered suture was performed. Eventually the healing was complete and satisfactory.

Conclusions: A severe bite avulsive wound on the lower lip, despite the elapsed time before treatment, may have an excellent prognosis after a simple surgical procedure.

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Figures

Figure 1
Figure 1
Clinical image: A human bite injury. Notice the severe lip tissue defect mimicking an ulcerative chronic process.
Figure 2
Figure 2
Surgical procedure. (a) and (b). After debridement a layered suture was performed. Notice vertical mattress stitches through the muscular-subcutaneous tissue and through the skin in order to get a stable primary wound closure.
Figure 3
Figure 3
Postoperative images. (a) and (b). After removing sutures.
See this image and copyright information in PMC

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