What to Do for Nose Skin Injury?

Traumatic Nasal Skin Injury and Recommendations for Aesthetic Recovery

Traumatic nasal skin injury, Nose injury, Nasal fractur
In the photo above, you can see the photo of the nose of the patient who accidentally hit the nose with hair (roofing material) and the photo after the aesthetic repair of the skin incision under local anesthesia. No nasal fracture was detected in the patient's X-ray and nasal examination. After the procedure, the patient's nose was bandaged with 3M brown micropore tape. In the other photo, healing at the wound site is seen after 3 weeks. The scar on the wound site has decreased considerably..

Our nose usually plays a protective role for our eyes in facial trauma

The patient above stated that his nose skin was cut when a hair blown by the wind hit his face while walking on the road. In traumas to the face, various levels of trauma and injury to the nasal bone and nasal skin may occur. No injury to the nasal bone was detected in the examination and radiographs of this patient. Sometimes, nasal injuries occur in patients who are punched in the face while fighting. Although the shape of the wound looks aesthetically bad here; It is much less life-threatening than an eye injury.

What to do when there is a traumatic injury to the nose

When you have a blow to your nose or a traumatic sharp object injury, it is of course ideal to consult a physician and have a general examination. It is important that patients do not have additional injuries, whether there is injury to the nasal bone or facial bones. If patients have nasal fractures, it should be evaluated whether there is displacement in the nasal bones.

What to do in simple nasal skin incisions

If there is bleeding in nasal skin incisions, you can print with a washed and ironed laundry (with sterile gauze if you can find it), if you are out of the house, you can press it with a paper towel and you should apply to a health institution as soon as possible. Avoid contact with dirty water to the wound area and if there is any soil, dirt, foreign dust particles in the wound area, it can be cleaned by pouring oxygenated water in your hand.

Skin incisions in areas parallel to the skin lines and in contact with less sunlight heal with fewer scars!

Incisions parallel to the folds of the nasal skin are less likely to leave scars. Again, the incision scar may remain darker in areas that are directly in contact with the sun's rays.

In the photo above, it is more likely to leave scars in areas with both skin cuts and skin crushes at the same time!

Since there is simultaneous crushing of the skin and subcutaneous tissue on the upper part of the triangular incision marked with the white arrow, more scars may remain in this area despite the aesthetic suturing.

Medical procedures in nasal skin traumatic injuries

After the wound site of the patients is evaluated, aesthetic skin and subcutaneous sutures are placed. 3M tapes can be adhered to the incision site of the patient, which reduces the contact of the sun's rays and at the same time does not prevent the air circulation of the skin. These tapes can be changed after a week. Antibiotic creams and epithelial creams that can reduce scar and color change can be applied to the incision area. After 1 month, a scar removal product such as Contractubex, Scarfade or ScarEx gel can be applied. Intracutaneous and transcutaneous suture techniques can be used to suture the skin incision. Generally, I prefer materials that can melt on their own and leave the least trace of seam tension in the form of scissors.

Protect the wound site from sun exposure to reduce discoloration during healing of the skin incision

The nasal dirsum region is in an area where the sun's rays are in intense contact. If you cover this area with hypoallergenic and microporous aesthetic tapes in the early period, you can reduce the contact of UV rays. Apart from this, sunscreen creams can be used after the first month. An application such as a solarium may cause an increase in the darkening of the incision marks on the nose.

Smoking has a negative effect on the healing of the skin incision!

The nicotine in cigarette smoke causes the diameter of the vessels to decrease and the circulation to be negatively affected. While carbon moxide causes the oxygenation of the wound to deteriorate; Particles in cigarette smoke directly increase the risk of infection in the ground. You should avoid smoking and contact with cigarette smoke before the incision on the skin of the nose is completely healed.

Avoid swimming in the pool and sea before the skin incision heals!

There is a connection between the capillary circulation in the lower 1/3 of our nose and the veins in the brain. Complete epithelialization of the incision area on the nasal skin may sometimes require longer than 1 month. During this period, especially the contact of pool water can seriously increase the risk of infection. In public pools disinfected with chlorine, various microorganisms with antibiotic resistance (even bacteria found in feces) can be found. Again, although sea waters are safer; It is not suitable to touch the open wound. It is ideal if you wait for some recovery. There is no tape that can protect the wound site from water contact for a long time.

It may be beneficial to use tape that brings the skin edges closer together in the area where there is a skin incision in the wound!

In injuries with superficial skin incisions, using only aesthetic tapes, bringing the skin incision ends closer together can reduce the scar that may appear at the wound site. In the above patient, since there was a deep skin incision, after the subcutaneous and skin were sutured, the wound was closed with tape only to cover the wound and to reduce the exposure to UV rays.

Foreign bodies in the incision area need to be cleaned

In some patients, foreign particles may be found inside the incision in the nasal skin, such as a piece of glass or metal. The causes of trauma can be asked to the patients in detail, and the incision sites can be evaluated with a magnifying glass or microscope if necessary. It is ideal to wash the wound area with antiseptic solutions or to remove flammable objects one by one mechanically for cleaning foreign bodies.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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