Management:
The patient was kept under antibiotic and analgesic therapy with
injection ceftriaxone (750mg/BD) and injection ketorolac (20mg/TDS). The
patient also received a booster dose of tetanus toxoid immunoglobulin.
Multidisciplinary team of Oral and Maxillofacial surgery and Department
of Pedodontics worked under general anesthesia for primary wound closure
in emergency operation theater. Initially cleansing and rinsing of the
wound was done using povidone-iodine and normal saline solution,
followed by marginal necrosectomy and debridement. Wound closure was
done at multiple layers. Suturing of the oral mucosa, parotid gland,
parotid capsule, and sub-dermal layer was done with 4-0 polyglactin
suture while 5-0 prolene suture was used on the superficial skin layer.
Post-operatively, patient was supported with antibiotics, analgesics,
and fluid supplements and dressing was done twice a day for 1 week.