Dr. Alfred Khallouf illustrates the steps taken to reconstruct lips following a traumatic injury. Please visit AlfredKhallouf.com to learn more.

1. Oral and Maxillofacial Surgery
TRAUMATIC
LIP INJURIES

3. Outline
● Anatomy
● Basic Surgical Principles
● Case reviews
● Summary

4. External Anatomy

5. Surgical Anatomy
● Skin
● Muscle
● Vasculature
● Mucosa

6. Basic Surgical Principles
● History of accident
● Medical status of the
patient
● Immunization history
● Don’t throw anything
away

7. Basic Surgical Principles
● Copious irrigation
● Exam
● Identify and align
landmarks
● Work inside to outside

8. Basic Surgical Principles
● Suture material related
to:
– Tissue type
– Age

9. Suture material

10. Suture material

11. Suture material

12. Principles of wound closure
● Anatomic closure
● Obliteration of dead
space
● Tension free
● Eversion of margins

13. Basic Surgical Principles
● Antibiotics
● Post op instructions
● Follow up
– Suture removal

15. ● History
● Medical status
● Save all tissues
● Irrigation
● Exam

16. ● Identify landmarks
● Suture materials

17. ● Antibiotics?
● Post – op
● Follow up

18. ● History
● Medical history
● Irrigation

20. ● Antibiotics?
● Immunizations
– Human rabies immune
globulin 20 IU/kg
- human diploid cell
vaccine (0, 3, 7, 14, 28)

21. ● History
● Medical history
● Irrigation
● Exam

23. Closure
Antibiotics?
Post op care

24. ● History
● Medical history
● Immunization
● Irrigation

26. ● Thorough exam
● Work inside to out
● Antibiotics?

27. ● History
● Medical history

29. ● Airway
● Extent of injury
● Oral intake
● Short term concerns
● Long term concerns

42. Post-op day 2

43. Post-op day 4

44. Post-op day 7

45. Post-op day 7

46. Post-op day 18

47. Post-op 2 Months
● Pearl
– Don’t throw anything
away!

54. Post-op day 3

55. Post-op day 5

56. Post-op Day 8

57. Post-op day 21

58. 2 December 2002

66. Summary
● Anatomy of the lips
● Surgical principles
● Different degrees of injuries

67. Pearls
● Clean wound and perform thorough exam
● Save all tissues
● 3 types of sutures required
– Fast absorbing gut
● Home care instructions

68. Pearls
● Antibiotics
– Keflex 500mg PO QID x 10 days
– Augmentin 875mg PO BID x 14 days
● Immunizations
– Tetanus prophylaxis
– Rabies status

69. Questions?