Adhesions are the consequence of mucosal damage to adjacent surfaces (Fig. 12.22). They can be minimized by creating space, treating mucosa with care, opening the olfactory cleft where there has been mucosal damage on both surfaces, asking the patient to douche vigorously three or more times a day, and reviewing the patient at one week and anesthetizing the mucosa with cophenylcaine and removing any strands of fibrous exudate that are starting to form. We have not found that splints or steroid creams improve matters, as they often appear to cause more local mucosal damage and stimulate fibrosis. Similarly, earlier debride-ment appears to delay healing and stimulate more fi-brosis. If adhesions are present preoperatively, they need more than sectioning in order to avoid them reforming. A segment of the adhesion needs to be removed with a through-cutting punch and more space created, followed by douching and debridement at one week.

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Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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