Resident Manual of Trauma to the Face, Head and Neck

Figure 9.5 Tearing and avulsive injury of left neck, chin, and lip following ejection through windshield. Tissues reapproximated in multiple layers, but unable to affix avulsed tissues back to mandibule. Lip closed with specific attention to vermillion closure, and Jackson-Pratt drain placed to evacuate large dead space from neck Levels I and II.

y y Consider clindamycin or trimethoprim-sulfamethoxazole (Bactrim™) if the patient is allergic to penicillin derivatives. 3. Oronasal-Involved Wounds (i.e., through-and-through lip lacerations) y y Clindamycin is typically used as a first-line treatment. y y Consider amoxicillin + clavulanate (Augmentin®), as well as a second- or third-generation cephalosporin (cefuroxime, ceftriaxone). 4. Ear or Nasal Cartilage Involvement y y Fluoroquinolones (ciprofloxacin, ofloxacin) provide good antipseudo- monal coverage and excellent cartilage penetration. 5. Animal Bites Some debate exists concerning the need for antibiotic prophylaxis. In general, consider in more complicated cases, such as immunocompro- mised victims, or in more extensive wounding.

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