Resident Manual of Trauma to the Face, Head and Neck

H. Chin..................................................................................................204 I. Neck.................................................................................................204 VI. Perioperative Care .............................................................................204 A. Antibiotic Prophylaxis.................................................................204 1. Uncontaminated Wounds <24 Hours Mature................204 2. Contaminated Wounds or Wounds >24 Hours Mature.....................................................................204 3. Oronasal Wounds (i.e., through-and-through lip lacerations)........................................................................ 205 4. Ear or Nasal Cartilage Involvement................................... 205 5. Animal Bites............................................................................ 205 6. Human Bites............................................................................206 B. Pros and Cons of Topical Antibiotics......................................206 1. Neomycin.................................................................................206 2. Bacitracin..................................................................................206 3. Mupirocin (e.g., Bactroban®).............................................. 207 C. Tetanus Prophylaxis..................................................................... 207 D. Post-Repair Directives................................................................. 207 1. Moisturization......................................................................... 207 2. Daily Debridement................................................................. 207 3. Dressings..................................................................................208 4. Bathing......................................................................................208 5. Antibiotics................................................................................208 6. Nutrition...................................................................................208 7. Head Elevation........................................................................208 8. Patient and Caretaker Instructions....................................208 9. Suture Removal.......................................................................208 10. Hypertrophic Scarring and Hyperemia.............................208 VII. Special Circumstances .....................................................................209 A. Abrasions.......................................................................................209 B. Avulsion Injuries...........................................................................209 C. Facial Nerve Injuries....................................................................209 D. Bite Injuries....................................................................................209 1. Animal Bites.............................................................................210 2. Human Bites.............................................................................210 E. Burn Injuries..................................................................................... 211 1. Facial Subsites.......................................................................... 212 VIII. Conclusion ........................................................................................... 213 IX. References ............................................................................................ 213

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