phenylephrine-hydrochloride and Bites--Human

In Germany about 8500 dog-bite injuries in the face occur every year; more than 50% of the victims are infants and schoolchildren. Besides dogs, other animals such as cats or horses may be responsible for these accidents. Even human bites are reported. The predominant areas are the nose and the auricles. The tissue defects may be superficial, but they can even cause amputations, including severe vascular and nerve or bony destruction. Systemic antibiotic therapy is needed when the wound is infected. The surgical approach to bite injuries includes local wound cleansing, careful excision of necrotic tissue and primary closure of the wound whenever possible. Regarding the importance of surgery in the head and neck area plastic-reconstructive techniques including autologous transplantations and various local or regional flaps should be used at the time the wound is first repaired.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Bites and Stings; Bites, Human; Cats; Child; Child, Preschool; Dogs; Ear; Facial Injuries; Germany; Horses; Humans; Nose; Rabies Vaccines; Tetanus Toxoid; Wound Infection

BACKGROUND The nasal ala is a paired structural subunit of the nose that is functionally important in the maintenance of the nasal valve. It consists of 3 anatomically distinct layers: skin, cartilage, and mucosa, all of which need to be restored in reconstructive surgeries to maintain nasal patency. When multiple layers are involved in a defect, the reconstruction requires combining procedures to replace each layer. CASE REPORT We describe a peculiar case of a 58-year-old man with a full-thickness loss of substance of the right nasal ala due to a human bite. The patient came to our hospital after an altercation with another man who bit his nose off. He was initially seen at a smaller regional hospital that did not have a plastic surgery department and was soon after transferred to our facility due to the complexity of the case. To reduce the risk of infection, the patient was treated with a complete course of intravenous antibiotic therapy and the wound was medicated daily with antiseptic solutions. The loss of substance was reconstructed with a composed graft from the auricle concha and the melolabial flap. CONCLUSIONS Defects of the nasal ala are challenging to reconstruct, given its complex 3-dimensional structure. The successful repair of these defects provides aesthetic symmetry and preserves nasal function. A wide variety of reconstructive options have been utilized in many nasal reconstruction cases and have been documented. The combination of a chondro-cutaneous graft from the auricular concha and a melolabial flap graft allowed a good result without local or systemic complications.

Topics: Autografts; Bites, Human; Humans; Male; Middle Aged; Nose; Rhinoplasty; Surgical Flaps

<b>Objectives:</b> Human bites of the face are a frequent and serious health issue as they often compromise patients function and aesthetics as well as lead to further complications. The aim of the study is to review human bites of the face referred to our team during 112 short-term medical missions (STMMs) in Sub-Saharan Africa over the past 20 years and to discuss the epidemiology, appearance, management and outcome, including the most common complications. <br><b>Methods:</b> A retrospective medical documentation review was carried out examining all human bites of the face operated by our team during 112 STMMs from 2000 to 2019 in different countries of Sub-Saharan Africa. <br><b>Results:</b> Out of about 5500 patients medical charts 51 patients were selected due to history of human bite. Patients' age range was 15-65 years, female to male ratio was 1, 55:1, the most often involved parts were: lips, ear and nose. Various surgical procedures were carried out including local flaps and free grafts. Infection and graft necrosis were the most common reported complication (n = 4; 9.3%). <br><b>Conclusion:</b> Human bites injuries are a serious health problem in some African populations because of their frequency and possible severity. The treatment is particularly challenging due to their potential to cause local infections, the risk they pose for transmission of systemic diseases as well as their demanding surgical management.

Topics: Adolescent; Adult; Aged; Bites, Human; Female; Humans; Male; Medical Missions; Middle Aged; Nose; Retrospective Studies; Treatment Outcome; Young Adult

The local anesthetics used in dentistry are considered very safe and have a low incidence of adverse reactions associated with their administration. A frequent finding by clinicians engaged in treatment of children is, following a dental appointment requiring local anesthesia to treat dental disease, a child may bite his or her lip out of curiosity associated with the unfamiliar sensation of being numb or inadvertently because no pain is felt. We describe two unusual case reports of postanesthetic self-inflicted injuries in this article. The first being the ulceration due to lip biting and the scratch injury on the chin after inferior alveolar nerve block. The second report presents an unusual scratch injury on the ala of nose following maxillary infiltration anesthesia. The common treatment modalities and the possible methods of prevention are discussed.

Topics: Anesthesia, Dental; Bites, Human; Child, Preschool; Chin; Follow-Up Studies; Humans; Lip; Male; Mandibular Nerve; Nerve Block; Nose; Skin Ulcer

Topics: Adult; Amputation, Traumatic; Bites, Human; Esthetics; Female; Follow-Up Studies; Graft Survival; Humans; Microsurgery; Nose; Replantation; Wound Healing

Human bite injuries are both deceptive and challenging in their presentation and management. They remain a frequent presentation to our unit, most often following late night alcohol fuelled aggression.. To audit the management of these wounds, with particular focus on infective complications and outcomes.. A three year retrospective chart review was undertaken on all patients referred to the plastic surgery unit from 1 January 2003 through to 31 December 2005.. A total of 92 patients with 96 human bite wounds were identified. The majority were male (92%). Alcohol consumption was documented in 86% of cases. The majority (70%) occurred over the weekend or on a public holiday. Facial injuries made up 70% of injuries with the remainder being to the upper limb. The ear was the most common target of all facial injuries (65%). Infection was documented in 18 cases (20%), with bite injuries to the upper limb and those presenting late (>12 h) having a higher incidence of infection.. Human bite wounds present a challenge to any emergency department, given the many issues involved in their management. Underestimation of the complexity and potential sequelae of these wounds will result in a suboptimal outcome for the patient.

Topics: Adolescent; Adult; Alcohol Drinking; Bites, Human; Ear; Emergencies; Facial Injuries; Female; Humans; Male; Medical Audit; Middle Aged; Nose; Retrospective Studies; Violence; Wound Infection

The microsurgical coverage of large nasal skin avulsion was performed in a 40 years old patient after a human bite. Widely exposing the columelle, the alar cartilages and the distal part of the septum, the defect was covered with a retroauricular free flap harvested on the superficial temporal pedicle and transferred on the upper labial vessels in the nasogenian area. Thanks to its excellent colour and texture match with the nose integuments, this flap enjoyed of an optimal integration in the centrofacial area. Its potential indications, advantages, drawbacks and technical variants are discussed in the present paper.

Topics: Adult; Bites, Human; Dermatologic Surgical Procedures; Follow-Up Studies; Humans; Male; Microsurgery; Nose; Rhinoplasty; Skin; Surgical Flaps; Time Factors

Retroauricular tissue for reconstruction of external nasal defects was described by Washio. We describe our recent experiences in elderly patients, in whom the risk of reconstruction after excision of a malignant growth is high. We present seven reconstructions, six after excision of malignant disease, together with our ideas about how to maximise its possibilities.

Topics: Adult; Aged; Aged, 80 and over; Bites, Human; Carcinoma, Basal Cell; Female; Humans; Male; Middle Aged; Nose; Plastic Surgery Procedures; Skin Neoplasms; Surgical Flaps; Treatment Outcome; Wounds and Injuries

Topics: Arm Injuries; Bites, Human; Central Nervous System; Child; Diagnosis, Differential; Humans; Hypoxanthine Phosphoribosyltransferase; Kidney Calculi; Lesch-Nyhan Syndrome; Lip; Male; Nose; Self Mutilation; Somatosensory Disorders; Tongue; Ultrasonography; Uric Acid

Topics: Adult; Bites, Human; Female; Humans; Nose; Plastic Surgery Procedures

Topics: Adult; Amputation, Traumatic; Bites, Human; Humans; Male; Microsurgery; Nose; Replantation; Suture Techniques

Topics: Adult; Bites, Human; Female; Humans; Male; Nose; Papua New Guinea; Rhinoplasty; Spouse Abuse; Surgical Flaps

A challenge to the microsurgeon is perfecting the technique of replantation of small pieces of facial tissue, mainly because of the extremely small size of the arteries as well as a lack of suitable veins for drainage. In the past 4 years, we have had seven cases of facial amputations, which included one scalp, two nasal tips, two ears, one lower lip, and one eyebrow. All of these patients were replanted/revascularized by microvascular anastomosis. Only two of the cases had suitable veins for anastomosis. Alternative techniques used for improving venous outflow were arterio-venous fistula, chemical leeches, and pin pricks. Four of the cases were completely successful, two cases had partial loss of the replant, and one case failed due to absence of venous drainage. In facial amputation, an aggressive microsurgical attempt will result in more tissue surviving and a better cosmetic outcome than in any other reconstructive procedures.

Topics: Adult; Amputation, Traumatic; Bites, Human; Ear; Eyebrows; Facial Injuries; Female; Humans; Lip; Male; Microsurgery; Middle Aged; Nose; Replantation; Scalp; Treatment Outcome

Forty-one human bites of the face are presented with a comparative review of earlier published series. Their primary treatment is outlined. The majority of bites presented few initial complications due to the excellent blood supply of the face and the use of prophylactic antibiotics. Secondary reconstruction, however, usually entailed multiple staged operations.

Topics: Adolescent; Adult; Age Factors; Bites and Stings; Bites, Human; Ear, External; Female; Humans; Lip; Male; Middle Aged; Nose; Surgery, Plastic

Topics: Adult; Aged; Bites, Human; Carcinoma, Basal Cell; Female; Humans; Lip; Middle Aged; Nose; Nose Deformities, Acquired; Nose Neoplasms; Rhinoplasty

Topics: Adult; Amputation, Traumatic; Animals; Bites and Stings; Bites, Human; Child; Child, Preschool; Dogs; Female; Humans; Infant; Nose; Skin Transplantation

Topics: Adult; Bites and Stings; Bites, Human; Cartilage; Ear, External; Humans; Lip; Male; Nose; Skin Transplantation; Surgery, Plastic; Transplantation, Autologous

Topics: Bites and Stings; Bites, Human; Face; Facial Injuries; Humans; Nose; Rabies Vaccines; Suture Techniques; Tetanus Antitoxin; Wound Healing

Topics: Adolescent; Adult; Aged; Bites and Stings; Bites, Human; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Face; Female; Humans; Male; Methods; Middle Aged; Nose; Nose Deformities, Acquired; Nose Neoplasms; Rhinoplasty; Skin Transplantation; Transplantation, Autologous