Facial Fracture Surgery Instructions

POST-OPERATIVE INSTRUCTIONS FOR FRACTURE PATIENTS

You have sustained a significant injury to your jaws. It may have been necessary to treat your fracture with wires, plates, or by a combination of both.
Normal healing time for jaw fractures is six to eight weeks.
It is important to follow the below instructions explicitly

1. Medications

You may be prescribed several medications depending on the nature of your injury. It is important to follow the label directions for all of the medicines in which you are prescribed. Depending on the nature of your injury, it may be necessary to treat your fracture with antibiotics. If antibiotics are prescribed, it is important to take them exactly as prescribed and to take the antibiotic until it is all gone.

Every effort will be made to give all medicines in the liquid form, however, some medications are not available in the liquid form, so it may be necessary to crush or dissolve your medicine in juice or water.

If you were taking any prescription medicines prior to your injury, please discuss this with your doctor.

2. Diet

The treatment of your broken jaw(s) will affect the way you eat. When your jaws are wired together you will be limited to a liquid or blenderized diet. If you have a blender or food processor, it will be very helpful in the preparation of your special diet.

Initially, due to swelling, the consistency of your food will be watery, but as time goes by and swelling decreases, the consistency of the food which you drink may be thicker. Use milk, water or broth to dilute foods in the blender.

If your case does not require that your teeth be wired together for the entire six to eight week period, it is still important that you do not chew foods during this healing period. The chewing of food during this time can loosen plates and screws. There are certain “no chew” food which you can eat such as puddings, mashed potatoes, and cooked vegetables and pasta mashed with a fork.

You will be given a dietary supplement (Ensure/Boost/Sustacal) to aid in your healing. It is important to add this to your diet. It is not uncommon to lose up to 10% of your body weight during the six to eight week period of having your teeth wired together.

3A. Home Care

Oral Hygiene: A clean mouth will aid healing. A soft-bristled toothbrush should be used around braces and wires, as they tend to trap food. If you have an incision in your mouth, your Doctor may instruct you to be cautious in this area during the first two weeks after surgery.

Additionally, you may be prescribed a special mouth rinse to aid in keeping your mouth clean.

Swelling: It may be beneficial to apply ice for the first 48 hours after surgery. The ice can be placed in a plastic bag and alternated from side-to-side 20 minutes on and 20 minutes off. After 48 hours, heat may be beneficial in decreasing swelling. A heating pad, hot water bottle, or washcloth with hot water can be used. Be careful not to make the water so hot as to scald the skin.

Swelling typically takes ten to 14 days to resolve. After the first four to seven days, swelling should begin to decrease. If you notice an increase in swelling after this time period, it may indicate an infection or other problem and you should call your doctor immediately.

Incision Care: Depending on the type of fracture, it may have been necessary to make an incision on your skin, or to repair lacerations or wounds associated with your injury. Your care of these wounds is important to prevent infection and minimize scarring. Unless otherwise instructed by your doctor, the bandage covering your stitches should remain in place until the stitches are removed. If your dressing comes off before the stitches are removed, care should be taken to avoid getting the stitches wet or dirty. A topical antibiotic ointment (Bacitracin, Polysporin) may be applied to the wound and stitches.

3B. Home Care

After stitches are removed the incision should be gently cleaned twice a day with soap and water or peroxide to remove crusting. A topical antibiotic ointment can be applied after each cleaning.

For the first six months, it is advisable to avoid excessive sun exposure to your scar. If you will be exposed to sunlight, you can apply sunblock to the scar and wear a wide brimmed hat to decrease the amount of sun exposure.

Activity: It is important to return to fairly normal lifestyle as soon as possible after injury. For the first two weeks after injury, we recommend that you avoid heavy lifting. Depending on the severity of your injury, this time could be longer. Your Doctor will discuss this with you.

Certain medications you may have received could affect your reaction time and judgment, therefore, it is critical that you do not drive or operate dangerous machinery for 24 hours after your general anesthesia or last dose of narcotic pain medication.

Alcohol may interact with your narcotic pain medication and may impair your ability to heal your fracture. Alcohol should be avoided for the duration of your treatment.

4. Braces and Wires

The braces and wires presently in your mouth are necessary for the immobilization and proper treatment of your fracture. It is normal over a period of time for the wires that hold your teeth together to become slightly loose. If your doctor feels the wires are too loose, he can re-tighten them at your follow-up appointment.

It is uncommon for the wires which hold your teeth together to come completely off or break, however, if this occurs call your doctor immediately.

PURPOSEFULLY CUTTING OFF THESE WIRES MAY LEAD TO INFECTION AND IMPROPER HEALING WHICH COULD RESULT IN THE NEED FOR ANOTHER OPERATION IN WHICH PART OF THE JAW MAY BE REMOVED DUE TO INFECTION.

It is quite common for the wires and braces to irritate gum and cheek tissue. If your wires begin to bother you, at your follow-up visit, ask your doctor for some wax, which can be placed over wires to provide relief from irritation.

5. Emergencies

A common question you may have is, “What if I get sick and my jaws are wired together?” The answer is first and foremost DON’T PANIC! Since your wires will only allow you to ingest liquid, you will only vomit liquid. Simply bend over and allow the liquid to run between the spaces around your teeth. If you believe it is an absolute EMERGENCY, you may cut the wires but you must notify your doctor immediately.

Occasionally, you may experience other symptoms, which you may wish to discuss with your doctor. Examples are:

Difficulty Breathing
Temperature > 102°F
Sustained Nausea

***** Our practice is available 24/7 to established patients*****

In the event of an emergency, you may contact Dr. Matthew Hilmi at (845) 340-1962.

5. Follow-up Care

It is absolutely critical that you attend your regularly scheduled follow-up appointments. Due to the severity of jaw injuries and potential for complications, you will need to be evaluated on a regularly scheduled basis until your doctor is assured adequate healing has occurred. Failure to attend follow-up appointments could result in further complications requiring further surgery.

If it is necessary to cancel or reschedule your follow-up appointments please call the office of Dr. Matthew Hilmi at (845) 340-1962.