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.