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Nasal Laceration, With Fracture, Suture Or Tape

A fractured nose causes pain, swelling, and nasal stuffiness. The fracture may be a minor hairline crack or a major break with the parts pushed out of place. Sometimes, there is also bleeding from the nose. By the next day, it is common to get bruising around the eyes from a broken nose.

A laceration will usually require stitches if it is deep. Minor cuts may be treated with surgical tape closures.

A minor fracture will heal in about 3–4 weeks with no additional treatment needed. A major break, causing a change in shape of the nose, will require straightening of the nasal bones (reduction) by an ENT doctor (nose specialist). Some fractures may need a reduction as soon as possible (such as those with continued bleeding). Otherwise, it is best to wait a few days until the swelling has gone down. This gives a better result since the doctor can easily see when the nose is back in the right position.

Home care

The following guidelines will help you care for your wound at home:

  1. If a bandage was applied and it becomes wet or dirty, replace it. Otherwise, leave it in place for the first 24 hours, then change it once a day.

  2. If sutures were used, clean the wound daily:

    • After removing the bandage, wash the area with soap and water. Use a wet cotton swab to loosen and remove any blood or crust that forms.

    • After cleaning, keep the wound clean and dry. Talk with your doctor before applying any antibiotic ointment to the wound. Reapply the bandage.

    • You may remove the bandage to shower as usual after the first 24 hours, but do not soak the area in water (no swimming) until the sutures or surgical tape closures are removed.

  3. If surgical tape closures were used, keep the area clean and dry. If it becomes wet, blot it dry with a towel.

  4. Apply an ice pack (ice cubes in a plastic bag, wrapped in a towel) over the injured area for 20 minutes every 1–2 hours the first day. Continue with ice packs 3–4 times a day for the next two days, then as needed for the relief of pain and swelling.

  5. The doctor may prescribe an antibiotic cream or ointment to prevent infection. Do not stop taking this medication until you have finished the prescribed course or the doctor tells you to stop. The doctor may also prescribe medications for pain. Follow the doctor’s instructions for taking these medications. If you have chronic liver or kidney disease or ever had a stomach ulcer or GI bleeding, talk with your doctor before using these medicines. Talk to your doctor if you are taking aspirin or blood thinners (coumadin). These will promote nose bleeding. Your dose may need to be adjusted.

  6. Avoid alcohol and hot liquids for the next two days. Alcohol or hot liquids in your mouth can dilate blood vessels in your nose and cause bleeding.

  7. Avoid blowing your nose for the first two days. Then, do so gently so you don't cause bleeding.

  8. Do not play contact sports in the next six weeks unless you can protect your nose from re-injury. Special custom-fitted plastic face masks are available for this purpose.

Follow-up care

Follow up with your health care provider. Most facial cuts heal in five days with no problem. However, even with proper treatment, a wound infection may occur. Check the wound daily for the warning signs listed below. Stitches should not be left in the face for more than five days; otherwise, permanent stitch marks may form. If surgical tape closures were used, you may remove them yourself after five days, unless told otherwise. If your nose appears crooked or if you cannot breathe through both nostrils after the swelling goes down, contact the referral doctor for an appointment to be seen within seven days of injury.

(Note: A radiologist will review any X-rays that were taken. We will notify you of any new findings that may affect your care.)

When to seek medical care

Get prompt medical attention if any of these occur:

  • If sutures come apart or fall out, or if surgical tape closures fall off before five days

  • Bleeding from the nose that is not controlled by pinching the nostrils together for 10 minutes (by the clock)

  • Increasing facial swelling, pain, or redness or pus

  • Fever of 100.4°F (38°C) or higher, or as directed by your health care provider

  • Unable to breathe from both sides of the nose after swelling goes down

  • Sinus pain

  • Repeated vomiting

  • Severe or worsening headache or dizziness

  • Unusual drowsiness, or unable to awaken as usual

  • Confusion or change in behavior or speech

  • Convulsion (seizure)

 

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