Closure and Dressing

Chapter 32. Closure and Dressing

Indications: Following completion of the preoperatively outlined goals and objectives, the surgeon should be pleased with the result. He should not leave the operating room if there is any uncertainty of the result. If he is satisfied, a closure should be performed. Both the open and endonasal techniques of rhinoplasty require sutures to close the incisions used for access. The former requires additional sutures to close the skin and subcutaneous tissues of the columella.

Approach: In general, the intranasal and external incisions are closed first, followed by placement of packing and application of an external dressing (Figure 32-1). The combination of internal packing and external splinting is commonly used to maintain the desired shape of the nose postoperatively. Internally, one or both nostrils are packed with material to provide support. Externally, the dorsum is covered with a protective splint.