A 5yrs kid with a/h/o accidental fall,trauma due to a sharp object(glass) over nose. No internal bleeding. Patient well concious and active. What is your diagnosis and further line of management?

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Lacerated wound nose. Adv. X-ray to rule out # nasal bone. Suture the wound with catgut in layers. Give antibiotics, antiinflammatories,local dressing with betadine cream. As face has rich blood supple wound will heal without scar.

Thanku sir
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# nasal bones and septum. Mx. X Ray lat view nasal bones, CBC Inj tranexa, ethamsylate Nasal Packing Antibiotics Analgesics Nasal bone # reduction/ rhinoplasty Pop cast

Thanku doc
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The injury has fractured nasal bones and cartilage Take care of that.under aseptic conditions clean suture and fusidin dressing. Give antibiotics. Brufen alternate dressins Keep a close watch for spread of swellig.Fever and bleeding etc

Suture the wound after cleaning, give TT, antibiotic Augmentin, Syp combiflam. Dressing of wound by betadine ointment. Follow dressing daily for 3-4 days, then on alternate days. Remove sutures after one week.

Thanku doc
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Survival of avulsed soft tissue flap is critical.just hitch the flap to fews suture without tension.do only loose dressing over it otherwise keep it open with some ointment application.further managament ll depend on soft tissue loss.

Thanku doc
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I agree with Dr. Bindia mam

Mx: Under aseptic precautions suture the wound with fine prolene and do proper dressing. Oral antibiotics for 5 days Syrup augmentin 1tsf BD and syrup ibugesic plus for pain management. Suture removal after 5 days.Nasal examination to rule out any septum involvement is crucial.

Thanku doc
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Maybe superficial injury but septum injury must be ruled out by x-ray. Act accordingly. Superficial injury may be repaired.

Thanku so much doctors for ur valuable time V had done xray wich was normal On parents demand case handed to plastic surgeon posted for nxt day Till then Simple dressing applied with antibiotic mangement

I completely agree with Dr. Anil as towards tip of nose the skin flap turning black coloured so flap survival is guarded. I feel loose sutures with neat approximation of edges should be done. Keep wound open and avoid rubbing during dressing just keep sutures area moist with normal saline drops on sutures. Can give hot fomentation over cheek Bt not cold compress. Tb bedanzene 5 my bid x 7 days and injured antibiotics to cover GM +ve n - ve flora. Check immunization status if needed give injured TT. If # nasal bones let the wound get healed first with an attempt to approximate # bones under GA when case taken for suturing but don't apply plaster cast. ....Hope for best out come

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