Patient Nose Prepped Explained for Students (Easy Guide)

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Original Question

The patient’s nose was prepped with Betadine prep and then draped in a sterile manner. Patient’s nose was packed with cotton pledgets soaked with 4% cocaine. After several minutes, an intranasal injection of 1% Xylocaine to 1:100,000 units epinephrine was made. In addition, infiltration was also done in the columella. Then utilizing a right hemitransfixion incision, bilateral mucoperichondrial and mucoperiosteal flaps were elevated. There was a significant amount of scarring around the cartilaginous septum. There were several fractures in the septum. Portions of the cartilaginous septum were missing. As such, under dissection there were several tears in the mucoperichondrium. Remnants of the cartilaginous septum were removed except for a dorsal strip. Portions of the bony septum were then removed. Spurs off the maxillary crest were also removed. The tears in the mucoperichondrium were reapproximated as best as possible with 4-0 chromic sutures. Attention was then focused on the columella. Utilizing an interior columella incision, the excess tissue at the base of the columella was excised. Excessive scar tissue was excised. Subsequently, a tip support was reconstructed with cartilaginous graft obtained from removed cartilaginous septum remnants. The medial crura were reapproximated with the cartilage graft. Signed Surgeon Signature 30540 30468 30520, 13151-59 30520

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