The Primary Closure Approach of Dog Bite Injuries of the Nose

Abstract

The nose holds an outstanding position on the face, acquiring great importance within the context of facial aesthetics. Because of the functional, psychological, and social aspects of trauma in a society increasingly demanding about aesthetics, treatment institution must reduce, as accurate as possible, the sequelae that hinder social integration. This clinical report relates an immediate nasal reconstruction of a complex animal bite wound. A 7-year-old patient was victim of a dog bite with avulsion of the left nasal ala and part of the ipsilateral nasal tip. The treatment was immediate nasal reconstruction with auricular composite graft. After 1 year of follow-up, the shape of nasal ala was stable, and the color was consistent with the surrounding tissue. The 2 nasal sides exhibited satisfactory symmetry when evaluated. It can be concluded that the composite graft derived from the auricular helix is a safe option for reconstruction of nasal ala defects with compromised margins in pediatric patients when conditions of reimplantation do not exist.

Alar Rim Composite Graft: A Safe and Simple Way to Correct Alar Retraction

“…In particular, shrinkage of a composite graft on the nose can be aesthetically objectionable. To prevent shrinkage, a modified composite graft was devised, in which the auricular cartilage is 2 to 3 mm wider than the auricular skin border [1]. This enables the easy insertion of the cartilage into the nostril recipient tissue and can strengthen the nasal framework, which minimizes the scar contracture that may occur after graft shrinkage [1].…”

“…The biggest limitation is that of size. Large composite grafts are infrequently used because a larger size reduces the survival rate of the graft [1]. Composite grafts require more metabolites than simple skin grafts and must undergo rapid revascularization to be successful [15].…”

“…The nose is a prominent feature that makes a major contribution to the aesthetics of the face [1]. Retraction or elevation (superolateral displacement) of the nostril rim can occur congenitally or iatrogenically due to scar contracture after various kinds of rhinoplasty [2].…”

Four Limb Shaped Auricular Chondrocutaneous Composite Graft for the Alar and the Columellar Defects

“…First, composite grafts are not frequently used in large defects because of the reduced survival rate [1]. Adams and Ratner [13] stated that the use of composite grafts is limited for large defects ( > 2 cm) due to their limited blood flow.…”

“…The nose has a dominant position on the face, and is of great importance in the context of facial aesthetics [1]. If trauma, tumor extirpation, or scar contracture causes defect or notching in the nose, aesthetic and functional problems occur as a result.…”