Post-Operative Considerations
- External dressings may compromise flap circulation, wrap exposed pedicle in xeroform gauze
- Open donor defect wounds should be kept moist with antibiotic ointment for the first 3 days, then Vaseline until secondary healing is complete
- Consider post-operative antiemetics
- Sutures are removed 5-7 days post-op. If there are concerns with flap viability, it may be improved by removing sutures earlier
Immediate:
- Pedicle division is performed in 3 weeks to allow sufficient neovascularization.
- Consider flap thinning and sculpting, as well as and cartilage grafting at this point or additional stages
- May require 3rd revision operation to establish patent nasal airway
- If there is hair follicles left on the distal end of the flap, these can be eliminated with a needle tip cautery at 2-3 months time
Long-term:
