(CR-062) Lip Reconstruction After Dog Bite Using a Dermal Regeneration Template: A Case Series

Martin Buta, MD, MBA – Plastic and Reconstructive Surgery Clinical Research Fellow, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital; Alexis Buckley, MD – Division of Plastic and Reconstructive Surgery – Massachusetts General Hospital; Seamus Caragher, MD, MPhil – Division of Plastic and Reconstructive Surgery – Massachusetts General Hospital; Henry Miller, MD – Division of Plastic and Reconstructive Surgery – Massachusetts General Hospital; Branko Bojovic, MD – Division of Plastic and Reconstructive Surgery – Massachusetts General Hospital

Introduction: Avulsion lip trauma resulting from a dog bite is a devastating injury that requires careful planning and operative and post-operative management to achieve an optimal outcome. In select cases, skin substitutes used during the primary repair can facilitate healing and may obviate the need for subsequent autologous skin grafting or complex reconstruction. Here we describe cases of single-stage application of a dermal regeneration template* to treat avulsion lip defects caused by dog bites.

Methods: A retrospective review of the electronic medical record was carried out on all patients 18 years and older with avulsion lip defects resulting from a dog bite who underwent reconstruction with a dermal regeneration template by the senior surgeon between January 2024 and November 2025. Patient demographics, wound characteristics, complications, and post-procedure course were analyzed. A successful outcome was defined as >95% re-epithelialization and reasonable function and cosmesis after single-stage wound matrix application without the need for additional coverage procedures. Primary outcomes of interest included time to wound closure, reoperation rate, and the use of skin grafting, local tissue rearrangement, flap, laser therapy, or filler.

Results: We identified 5 patients (all female, mean age: 39.8 years, SD: 7.6) who underwent avulsion lip reconstruction using a dermal regeneration template. The mean wound area treated was 3.4 cm² (SD: 0.37). One patient underwent intraoperative application in the days following injury, one underwent application in the clinic, and three underwent application in the emergency room at the time of injury. All were treated with preventative antibiotics. No patients underwent subsequent autologous skin graft or a locoregional flap due to incomplete re-epithelialization. In all patients, lip reconstruction after single-stage wound matrix application achieved reasonable functional and aesthetic outcomes without complication and with patient satisfaction.

Discussion: A dermal regeneration template can be safely and reliably used for single-stage reconstruction of select avulsion lip defects resulting from dog bites. Larger and comparative studies are needed to further investigate dermal matrix selection, and specific patient and lip wound characteristics, for optimal outcomes.