Provider Prepared's Weekly Pearl of Wound Wisdom #30 Knowing the Nose
A 30-year-old male presents to the emergency department with laceration to the left side of his nose after being involved in a mountain bike accident. On evaluation there is no extension of the laceration into any of the cartilaginous structures. With soft tissue involvement only the wound is appropriate for repair without the need for specialty consultation.
Lacerations to the nose that involve the entrance of the nare require special attention. The alar margins should be used as a guide to ensure proper alignment. Suturing should be done using 6–0 nonabsorbable suturing material in a simple interrupted fashion. The curvature of the nose must be taken into consideration as the wound is carefully repaired to achieve appropriate shape and alignment. Exposed cartilage should be appropriately covered with reapproximation of the overlying tissue to ensure no development of infection. Lacerations involving the mucosal surfaces should be closed using absorbable suture.
Hollander, JU et al. Assessment and management of facial lacertions. UpToDate November 2017.
Nathan Whittaker, MD
- Brandon Durfee