Limiting oedema, ecchymosis and haemorrhage in septorhinoplasty with ice cooled swabs.

Abstract

Oedema, ecchymosis and bleeding involving the skin envelope can create difficulties during septorhinoplasty. The application of ice cooled swabs may reduce these complications. Sterile, saline soaked, gauze swabs are wrapped around a routinely available 500ml pre-frozen, sterile fluid bag by the scrub assistant (Fig 1). Prior to application, the swabs are immersed briefly in cold water to avoid thermal injury to exposed skin. Figure 1 Sterile, saline soaked, gauze swabs wrapped around a 500ml pre-frozen, sterile fluid bag Compression of the nasal dorsum with ice cooled, wet swabs at intervals intraoperatively (Fig 2) can result in less distortion during reconstruction, more accurate incision closure, reduced need for nasal packing and shorter operating times.1 This is likely to facilitate a better postoperative cosmetic result. Figure 2 Compression of the nasal dorsum with ice cooled, wet swab