Cosmetic Surgery Research Today is a free monthly online journal that collates and summarizes the latest research about Cosmetic Surgery, including details on microsurgery, reconstruction, techniques, risks.

Audit of nasal fracture management in accident and emergency in a district general hospital.

Agrawal N, Brayley N

ENT Surgery, Guy's and St Thomas' NHS Trust, London, UK. namitagrawal@yahoo.com

RATIONALE: Nasal fractures are a common occurrence in accident and emergency and dealt with by inexperienced senior house officers. This can lead to inappropriate X-rays being performed, no proper documentation of septal haematomas and often no follow-up with a specialist team leading to in some cases complex cosmetic surgery whereas simple manipulation may have sufficed. METHOD: We report an ambispective audit carried out on nasal fracture management in a busy district general hospital over a 6-month period. RESULTS: 46 patients were seen 24 in the first 3 months and 22 the next three. 10 had nasal X-ray performed initially on audit. Nine had no documentation of septal haematoma and seven had no follow-up arranged. After appropriate education and the setting up of a department protocol based on best practice, the next cycle was repeated. Two nasal X-rays were performed looking for foreign bodies, all patients had appropriate documentation of septal haematoma and appropriate follow-up. CONCLUSION: Appropriate education and implementation of departmental guidelines can result in more effective and efficient use of resources when dealing with nasal fractures in accident and emergency.

Published 23 March 2007 in J Eval Clin Pract, 13(2): 295-7.
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