Authors of section

Author

Boaz Arzi

Executive Editor

Amy Kapatkin

General Editor

Frank Verstraete

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Soft tissue debridement/management

1. Principles

Debridement of the damaged edges should be done delicately. Care should be taken to avoid damage to the palatine arteries.

midface palatal nondisplaced

2. Positioning and approach

This procedure is performed through the intraoral approach to the hard palate, with the patient placed in dorsal recumbency.

3. Debridement

Copious irrigation with sterile saline is performed. General oral rinse is performed prior to surgery.

The palatal tissue at the edge of the trauma is gently elevated using a periosteal elevator.

soft tissue debridement management

4. Closure

The palate is sutured in a single layer closure using 4-0/5-0 poliglecaprone (or other monofilament absorbable suture) in a simple-interrupted fashion. Gentle tissue handling is indicated to avoid tearing of the palatal tissue.

soft tissue debridement management

5. Aftercare

The dog should be kept on soft food for one or two weeks after surgery.

Intraoperative intravenous administration and then oral antibiotics for one to two weeks is recommended. Antibiotics used should have an excellent oral cavity penetration and spectrum. Example: ampicillin at 20 mg/kg intravenous antibiotics followed by oral antibiotics amoxicillin/clavulanic acid at 15-20 mg/kg orally twice daily.

Pain medication, such as opioids and non-steroidal anti-inflammatory medications, are used for 7-14 days.

If the fracture involved the oral cavity, oral rinse with 0.05-0.12% chlorhexidine gluconate solution is recommended (not for maxillomandibular fixation).

Recheck is recommended in 10-14 days and at three and six months post-surgery.

If there are any signs of complications (i.e. purulent nasal discharge), CT and rhinoscopy are indicated.