Use of Karapandzic flap in lower lip reconstruction after human bite

Abstract

Objective: To describe the management and reconstruction of an extensive lower lip avulsion caused by a human bite, highlighting the Karapandzic flap as the reconstructive technique. Case report: A healthy 49-year-old male presented with an extensive lower lip avulsion resulting from a human bite, involving approximately 64% of its total length. After clinical evaluation and informed consent, a reconstructive approach consistent with the magnitude of the tissue loss was required. Renner’s (2022) algorithm indicated the Karapandzic flap, recommended for defects between 50-80%, due to its ability to preserve vascularization, in nervation, and perioral mobility. The procedure was performed under general anesthesia, with bilateral semicircular incisions and careful dissection to maintain the mental neurovascular bundles and inferior labial arteries. Symmetrical rotation and advancement of the flaps enabled primary closure without grafts. Layered repair included the orbicularis oris muscle, mucosa, and skin, respecting the vermilion border. Post operatively, antibiotic therapy and tetanus prophylaxis were instituted. The patient showed uneventful healing, with preserved symmetry, sensation, and lip mobility, as well as satisfactory functional evaluation. Conclusion: The Karapandzic flap proved to be a safe and effective option for extensive lip reconstruction, allowing adequate restoration of oral function and esthetics.