Immediate Nasal Reconstruction Using Avulsed Native Nasal Skin After Trauma

Summary: Reconstruction of nasal skin poses significant challenges due to its thickness, sebaceous nature, and high bacterial colonization. Full-thickness nasal skin grafting is extremely rare, as native nasal skin is not commonly used as a donor site. This report describes a unique case of successful reconstruction using avulsed native nasal skin following trauma. A healthy man in his 60s sustained a complete avulsion of the nasal skin after a fall. The avulsed skin, initially discarded, was retrieved and prepared as a graft. Thorough disinfection and aggressive thinning were performed to optimize graft take. The graft was secured using a tie-over dressing under local anesthesia in the emergency room. The graft achieved full survival without the need for secondary interventions. Mild postoperative erythema resolved completely after 6 months of topical diclofenac therapy. This case demonstrates that avulsed native nasal skin can be successfully repurposed for nasal reconstruction when carefully prepared. Key factors for success included meticulous thinning and rigorous disinfection to counter the sebaceous and microbial challenges of nasal skin. Further studies may be beneficial to define the limitations and optimal management strategies for nasal skin grafting.