lip reconstruction following traumatic lip injuries | dr. alfred khallouf
TRANSCRIPT
Oral and Maxillofacial Surgery
TRAUMATIC
LIP INJURIES
Outline
● Anatomy ● Basic Surgical Principles ● Case reviews ● Summary
External Anatomy
Surgical Anatomy
● Skin ● Muscle ● Vasculature ● Mucosa
Basic Surgical Principles
● History of accident ● Medical status of the
patient ● Immunization history ● Don’t throw anything
away
Basic Surgical Principles
● Copious irrigation ● Exam ● Identify and align
landmarks ● Work inside to outside
Basic Surgical Principles
● Suture material related to: – Tissue type – Age
Suture material
Suture material
Suture material
Principles of wound closure
● Anatomic closure ● Obliteration of dead
space ● Tension free ● Eversion of margins
Basic Surgical Principles
● Antibiotics ● Post op instructions ● Follow up
– Suture removal
● History ● Medical status ● Save all tissues ● Irrigation ● Exam
● Identify landmarks ● Suture materials
● Antibiotics? ● Post – op ● Follow up
● History ● Medical history ● Irrigation
● Antibiotics? ● Immunizations
– Human rabies immune globulin 20 IU/kg
- human diploid cell vaccine (0, 3, 7, 14, 28)
● History ● Medical history ● Irrigation ● Exam
Closure Antibiotics? Post op care
● History ● Medical history ● Immunization ● Irrigation
● Thorough exam ● Work inside to out ● Antibiotics?
● History ● Medical history
● Airway ● Extent of injury ● Oral intake ● Short term concerns ● Long term concerns
Post-op day 2
Post-op day 4
Post-op day 7
Post-op day 7
Post-op day 18
Post-op 2 Months
● Pearl – Don’t throw anything
away!
Post-op day 3
Post-op day 5
Post-op Day 8
Post-op day 21
2 December 2002
Summary
● Anatomy of the lips ● Surgical principles ● Different degrees of injuries
Pearls
● Clean wound and perform thorough exam ● Save all tissues ● 3 types of sutures required
– Fast absorbing gut ● Home care instructions
Pearls
● Antibiotics – Keflex 500mg PO QID x 10 days – Augmentin 875mg PO BID x 14 days
● Immunizations – Tetanus prophylaxis – Rabies status
Questions?