Facial and Lip Reconstruction due to Animal Bite with Local Advancement Flap and Estlander Flap: A Case Series

Abstrak

Background: Animal bites frequently result in facial disfigurement, as well as crush and avulsion injuries due to their sharp teeth and powerful jaws, and facial and lip reconstruction due to dog bite is a challenging surgical procedure with a high level of difficulty. 
Case: This case series reports three patients with facial and lip defects following dog bites: a 41-year-old female with an open degloving wound up to 10 x 3 cm involving the right upper and lower eyelids with partial loss of upper lateral cartilage and inner lining of nasal mucosa and complete loss of lower lateral cartilage managed with local advancement flap followed by planned alarplasty and rhinoplasty; a 23-year-old male with a full-thickness defect at the lateral one-third of the upper lip with 5 x 1.5 cm soft tissue loss; and a 7-year-old girl with a full-thickness defect at the lateral one-third of the upper lip with 3 x 1 cm soft tissue loss, both managed with Estlander flap. All surgeries went uneventful without significant complications, and three-months follow-up showed viable flaps with satisfactory aesthetic and functional outcomes in all patients. 
Conclusion: Estlander flap can be used for primary lip reconstruction, defects at the oral commissure, and reconstruction of defects ranging from one-third to two-thirds of the lip, including the corner of the mouth, making it an excellent alternative for preserving facial aesthetics and function in facial and lip injuries caused by dog bites.