Microsurgical Mini-Sized Lip Replantation-A Case Report and Literature Review

Background: Avulsion injury of lip is a rare condition and is challenge to restore both of the functional and aesthetic outcome. Aim and Objectives: Specifically, for minimal segment of lower lip amputation, we proposed a successful case that replantation was carried out by only one arterial revascularization with an interposition of vein graft which is an effective and reliable method to restore both the functional and aesthetic outcome. Materials and Methods: We present a 48-year-old female patient with a traumatic avulsion injury of partial lower lip, resulting from a dog bite. A small piece of the lower lip, consisting of the vermillion and both of the mucosal and myocutaneous flap was brought. We performed an emergent replantation with vein grafts harvested from left forearm. Post-operative anticoagulants and antibiotics were used for one week. After discharged from the hospital, we followed up this patient regularly in the out-patient clinic. Serial photographs of lesion site were taken during each out-patient visit as part of our clinical assessment and documentation. Results: After the surgery, the replanted tissue turn congested initially and resolved after medication. Crusting coverage was removed gradually in our out-patient clinic. The results of aesthetic and functional outcome were satisfied in all terms of form, colour match, texture, contour and the sensitivity. However, hypertrophic scar of the replanted tissue and the suture line over the forearm was noted and still under observation at our out-patients clinic. Conclusion: We demonstrated that replantation carried out by only one arterial revascularization with an interposition of a vein graft is an effective and reliable way for restoration both the functional and aesthetic results of avulsed minimal segment of lower lip.