Successful Non-Microvascular Nasal Tip Replantation After Traumatic Avulsion

Objectives: To present a case of a traumatic avulsion of the nasal tip treated successfully with non-microvascular replantation Methods: Illustrative case report Results: A 37-year-old male presented to Thomas Jefferson University Hospital with a traumatic avulsion of his nasal tip from a human bite. The avulsed tissue was 2cm in size, included the lower lateral cartilage and involved multiple subunits of the nose. Replantation was performed 8 hours after the traumatic incident. Leeches were applied to the re-implanted tissue immediately following surgical repair. Two weeks after surgery 80% graft survival was noted. The residual defect was reconstructed with a pedicled columellar graft. Conclusions: This case presents evidence that non-microvascular replantation of full thickness composite tissue can result in survival with acceptable clinical outcomes. In this particular case, tissue survival obviated forehead flap reconstruction and its associated morbidity. Future studies to determine the effects of time, size and leech therapy on replanted tissues are needed.