Wound infections following rhinoplasty are uncommon. In the majority of cases the causative bacteria is either staphylococcus or streptococcus. They usually show up approximately 5 to 7 days following surgery and sometimes later. Certain factors may predispose to postop wound infections such as the use of synthetic implants or decreased immunity which may be due to systemic conditions or the use of various drugs. The majority of surgeons use antibiotics at the time of surgery and for a variable period of time afterwards in an effort to decrease the incidence of wound infection, however, their value has not been scientifically proven.
By examining your nose the surgeon will be able to determine if infection is a concern. There may be other factors that are causing the differential redness. If the surgeon suspects that there is an infection present then one or more courses of action are appropriate:
· Incision and drainage. Re-opening one of the incisions for a short distance and draining any trapped pus.
· Culture and Sensitivity. Attempting to identify what bacteria are responsible and what antibiotics are most appropriate. This requires collecting a swab specimen of any drainage that can be produced and submitting for microbiologic testing which takes 2 to 3 days.
· Antibiotic treatment. Until the results of the culture and sensitivity are available, it is wise to start treatment right away with empiric antibiotics assuming that the infection is a staph or strep species. Once the test results are available, the antibiotics can be changed if necessary.
Mario J. Imola, MD, DDS, FRCSC, FACS.