Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap

The goals of lip reconstruction include oral competence with adequate mouth opening, lip motion, and minimizing secondary deformity. Although microvascular tissue transfer is considered the gold standard for total lip reconstruction, these complex reconstructions are fraught with complications, the...

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Main Authors: Shashikant V. Agarwal, Riaz Y. Seedat
Format: Article
Language:English
Published: Elsevier 2020-10-01
Series:Journal of Pediatric Surgery Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213576620302232
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author Shashikant V. Agarwal
Riaz Y. Seedat
author_facet Shashikant V. Agarwal
Riaz Y. Seedat
author_sort Shashikant V. Agarwal
collection DOAJ
description The goals of lip reconstruction include oral competence with adequate mouth opening, lip motion, and minimizing secondary deformity. Although microvascular tissue transfer is considered the gold standard for total lip reconstruction, these complex reconstructions are fraught with complications, the propensity of which increases in the pediatric population given the smaller vessel size. Facilities for performing microvascular reconstruction are often not available in developing world settings. We report a five year old child who presented with large avulsion injuries of the lower half of the face, including total loss of the upper and lower lips, left cheek, left ear and right commissure after being attacked by dogs. In the absence of the resources to perform a microvascular free flap reconstruction, a deltopectoral flap was successfully used to repair both upper and lower lips. In a resource constrained environment, total reconstruction of both the upper and lower lips can be achieved using local or regional tissues with similar outcomes to that derived from microsurgery.
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spelling doaj.art-ccfc4ae0afa84612a2a83047b673d0f02022-12-21T19:38:42ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662020-10-0161101589Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flapShashikant V. Agarwal0Riaz Y. Seedat1Department of Plastic and Reconstructive Surgery, University of Free State and Universitas Academic Hospital, Bloemfontein, South AfricaDepartment of Otorhinolaryngology, University of Free State and Universitas Academic Hospital, Bloemfontein, South Africa; Corresponding author. Department of Otorhinolaryngology, University of Free State, P.O. Box 339, Bloemfontein, 9300, South Africa.The goals of lip reconstruction include oral competence with adequate mouth opening, lip motion, and minimizing secondary deformity. Although microvascular tissue transfer is considered the gold standard for total lip reconstruction, these complex reconstructions are fraught with complications, the propensity of which increases in the pediatric population given the smaller vessel size. Facilities for performing microvascular reconstruction are often not available in developing world settings. We report a five year old child who presented with large avulsion injuries of the lower half of the face, including total loss of the upper and lower lips, left cheek, left ear and right commissure after being attacked by dogs. In the absence of the resources to perform a microvascular free flap reconstruction, a deltopectoral flap was successfully used to repair both upper and lower lips. In a resource constrained environment, total reconstruction of both the upper and lower lips can be achieved using local or regional tissues with similar outcomes to that derived from microsurgery.http://www.sciencedirect.com/science/article/pii/S2213576620302232Lip diseasesSurgical flapReconstructive surgical proceduresChild
spellingShingle Shashikant V. Agarwal
Riaz Y. Seedat
Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap
Journal of Pediatric Surgery Case Reports
Lip diseases
Surgical flap
Reconstructive surgical procedures
Child
title Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap
title_full Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap
title_fullStr Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap
title_full_unstemmed Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap
title_short Simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap
title_sort simultaneous reconstruction of complete upper and lower lip defects in a child using a vertically split delayed pedicled deltopectoral flap
topic Lip diseases
Surgical flap
Reconstructive surgical procedures
Child
url http://www.sciencedirect.com/science/article/pii/S2213576620302232
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