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y
y
Consider clindamycin or trimethoprim-sulfamethoxazole (Bactrim™)
if the patient is allergic to penicillin derivatives.
3. Oronasal-Involved Wounds (i.e., through-and-through lip
lacerations)
y
y
Clindamycin is typically used as a first-line treatment.
y
y
Consider amoxicillin + clavulanate (Augmentin®), as well as a
second- or third-generation cephalosporin (cefuroxime, ceftriaxone).
4. Ear or Nasal Cartilage Involvement
y
y
Fluoroquinolones (ciprofloxacin, ofloxacin) provide good antipseudo-
monal coverage and excellent cartilage penetration.
5. Animal Bites
Some debate exists concerning the need for antibiotic prophylaxis. In
general, consider in more complicated cases, such as immunocompro-
mised victims, or in more extensive wounding.
Figure 9.5
Tearing and avulsive injury of left
neck, chin, and lip following ejection
through windshield. Tissues
reapproximated in multiple layers,
but unable to affix avulsed tissues
back to mandibule. Lip closed with
specific attention to vermillion
closure, and Jackson-Pratt drain
placed to evacuate large dead space
from neck Levels I and II.