Reconstruction of a nasal tip defect – a case report

Abstract

The purpose. Objectives and Aim of the Study. This study aims to integrate reconstructive surgery principles in nasal wound repair using objective assessment methods and dynamic monitoring, and to demonstrate the uniqueness of our proposed case for anatomical, functional, and aesthetic restoration. Materials and methods. We present a clinical case of skin and soft tissue defect at the nasal tip caused by a dog bite in a military serviceman who was treated at the surgical department of the Military Medical Clinical Centre of the Eastern Region, Dnipro.  The classification of soft tissue defects by area, volume, and localisation (Ukrainian Military Medical Academy, 2018) was used to assess the cutaneous defect during the treatment. Results. It has been demonstrated that wound defect reconstruction of the nose using the rotation flap technique (Rotation Flap) is the primary method for restoring anatomical integrity of nasal covering tissues. Using objective examination methods, such as thermography, audio Doppler ultrasonography, CT angiography, and pulse oximetry, demonstrates the anatomical foundation for effective closure of nasal defects with rotational forehead flap. Conclusions.  Preoperative planning is accomplished by objectively evaluating clinical changes in the damaged anatomical structure (dynamic digital thermography, audio Doppler, CT angiography). Pre-, intra-, and postoperative monitoring validates the clinical transformation of vascular architecture and enables study of integration dynamics within the wound defect, thereby reducing functional recovery duration. Nasal wound defect restoration using the rotation flap technique provides the foundation for reestablishing the anatomical integrity of nasal covering tissues. The presented approach enables comprehensive reconstruction that is both anatomical and aesthetic; it improves the patient’s overall psychological well-being and quality of daily life, while offering advantages in hospitalisation duration. The forehead flap represents the method of choice for surgical reconstruction of nasal tip defects, with limited contraindications for its implementation. Three to four weeks of patient discomfort during the postoperative period represents a modest price for durable, proper nasal reconstruction.