Pediatric Nasal Tip Amputation Successfully Treated with Nonmicrovascular Replantation and Hyperbaric Oxygen Therapy

Nasal tip amputation is a rare but difficult problem to manage. Nonmicrovascular nasal tip replantation is a valid and relatively simple repair option for moderate nasal defects, but tissue ischemia and graft failure occur frequently. We present the case of a pediatric nasal tip amputation from a dog bite treated with replantation within 5 hours. The 2.5-cm avulsed tip contained skin, cartilage, and mucosa and was replanted as a 3-layer composite graft. Hyperbaric oxygen (HBO) therapy was initiated for 2 weeks postoperatively. The outcome was functionally adequate, and the majority of the native nasal tissue was salvaged. HBO therapy can be used after nonmicrovascular nasal tip replantation to improve graft survival and potentially decrease the need for revision surgery.