The Abbe flap is a popular local flap option for lip defect reconstruction. We describe a case never reported in the literature – accidental injury to the supplying vessel (superior labial artery) and subsequent microsurgical repair.
A 62 year old man underwent wedge resection of the right lower lip for excision of biopsy proven SCC.
Abbe flap reconstruction was performed in standard fashion.
While raising the flap the superior labial artery was inadvertently injured – full thickness ~50% of circumference.
The vessel was repaired micro surgically with interrupted 10-0 Nylon suture with good flow post repair.
Flap survival was 100% with minimal congestion post operatively. The aesthetic result was excellent as expected from this flap design.
Inadvertent arterial injury in axial pattern local flap reconstruction is rare for the Abbe flap. This case suggests that management with microsurgical repair of the superior labial artery will allow this flap to survive.