Plastic and Reconstructive Surgery, Global Open (Nov 2022)

Posttraumatic Lip Replantation in a Pregnant Woman

  • Seamus P. Caragher, BS,
  • Charles D. Hwang, MD,
  • Jason C. Gardenier, MD,
  • Kimberly S. Khouri, MD,
  • Martin R. Buta, MD,
  • Justin C. McCarty, MD,
  • Olivia A. Ford, MD,
  • Ashley Ehret, MD,
  • Curtis L. Cetrulo, MD

DOI
https://doi.org/10.1097/GOX.0000000000004662
Journal volume & issue
Vol. 10, no. 11
p. e4662

Abstract

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Summary:. Traumatic lip amputation is a devastating injury. No other tissue replicates its unique histology, often limiting the reconstructive outcome. Replantation is a technically challenging procedure, requiring extensive postoperative optimization, including systemic anticoagulation, leech therapy, significant blood loss, and antibiosis. Given the rarity of replantation in the context of pregnancy, there are no documented accounts of lip replantation in pregnant patients. We report a case of a 25-year-old pregnant woman who sustained an avulsion injury of the right upper lip from a dog bite. The patient presented with the amputated lip and emergent microvascular replantation was performed. Postoperative course consisted of management of controlled yet significant blood loss through leech therapy and close collaboration with obstetric colleagues. The patient was ultimately discharged with successful cosmetic and functional outcome and, importantly, with maintenance of a healthy pregnancy.