Composite grafting and hyperbaric oxygen therapy in pediatric nasal tip reconstruction after avulsive dog-bite injury

It is estimated that more than four million people are bitten by dogs in th e United States each year. The majority of such injuries are minor, and the ir treatment does not usually require surgical consultation. However, the a uthors report a case in which a Rottweiler inflicted a mutilating nasal tip /alar rim avulsion on a 5-year-old boy. They report their experience with i mmediate reconstruction of the nasal defect using a large ipsilateral auric ular cartilage composite graft (crus helix). Adjunctive hyperbaric oxygen t herapy (without sedation or anesthesia) was used to maximize the stimulus f or graft revascularization. Reconstructive goals were achieved while avoidi ng the need for a central facial donor site defect.