Pediatric Nasal Tip Amputation Successfully Treated with Nonmicrovascular Replantation and Hyperbaric Oxygen Therapy.

Background: Nasal tip amputation is a rare but difficult problem to manage. Nonmicrovascular nasal tip replantation is a valid and relatively simple repair option for moderate nasal defects, but tissue ischemia and graft failure occur frequently. Case Report: We present the case of a pediatric nasal tip amputation from a dog bite treated with replantation within 5 hours. The 2.5-cm avulsed tip contained skin, cartilage, and mucosa and was replanted as a 3-layer composite graft. Hyperbaric oxygen (HBO) therapy was initiated for 2 weeks postoperatively. The outcome was functionally adequate, and the majority of the native nasal tissue was salvaged. Conclusion: HBO therapy can be used after nonmicrovascular nasal tip replantation to improve graft survival and potentially decrease the need for revision surgery.