Management of a Lower Lip Avulsion Injury Due to a Human Bite

The present case report illustrates the management of an avulsion involving two-thirds of the lower lip. An unsuccessful attempt at microsurgical replantation led to a trial of composite tissue engraftment. Ultimately, the tissue sloughed, and after minimal debridement, the defect was treated by direct approximation of mucosa, muscle and skin. The treatment decisions made in caring for this injury show the challenge of microsurgical tissue replantation, the unpredictability of the composite graft and the benefit of having enough tissue to consider direct tissue approximation. Clearly, lips are worth every attempt at preservation, given their functional, cosmetic and psychological importance.