Human bite, Tissue loss, Reconstructive armamentarium
A retrospective series of thirty-six cases of human bites to the face with tissue losses requiring reconstruction during a five-year period, January 1999 to December 2003 is presented. The unmarried female in her third decade dominated both as victim and assailant in incidences related to love affairs and love gone sour. The middle third of the lower lip was the most commonly bitten part with a majority of these presenting early. Copious larvage under broad-spectrum systemic antibiotic cover as well as anti-tetanus regimen allowed delayed primary repair in the first week of injury in a majority of the patients. Our reconstructive armamentarium included V-excisions and closure for lip defects, the superiorly based naso-labial flap for nasal ala defects and the retro-auricular tubed flap for helical rim and ear-lobe defects. Outcome was generally satisfactory though a longer follow-up data is desirable. Experience with hypertrophic scarring and keloid formation in our patient population continues to be a major factor in the choice of reconstructive techniques in our regional practice.