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

Abstract

Abstract 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.