17.  Discuss the various possible dressings after rhinoplasty.  Include internal nasal splints.  How long should the nose be packed?  What are the dangers of packing?  How long should the external dressing be worn?

Answer:
1) Packing with vaseline gauze or rolled telfa or adaptic gauze.
2) External splints made from tape (layer of paper followed by layer of cloth then plaster), cast, moldable plastics.
3) Internal splints: mattress sutures through sheets of silastic rubber or other substances cut to size on either side of the septum to provide support for the septum when multiple incisions have been made through the septum.

Danger of packing:
1) Choking on the packing as it goes down the throat.
2) Toxic Shock Syndrome.
3) Pressure ischemia.
4) Overpacking of one side leading to asymmetrical splinting.

Packing should be removed in 1-3 days and the patient should be on oral antibiotics.
 

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