What is Septal Hematoma Drainage

A septal hematoma is a blood clot in the thin wall that divides your nose into two parts (septum). This condition is treated by draining the hematoma. If left untreated, a septal hematoma can quickly turn into an infection (septal abscess).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Previous problems you or members of your family have had with the use of anesthetics.
• Any blood disorders you have.
• Previous surgeries you have had.
• Any medical conditions you have.
• Any recent upper respiratory infections you have had, such as a cold.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• You may be given antibiotic medicine to help prevent infection.
• You may have an exam or testing, such as:
  • Blood tests.
  • X-rays or other imaging studies.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube may be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your health care provider will make a cut over the hematoma.
• The hematoma will be drained. If there is any evidence of a septal abscess, that will be drained too.
• Your health care provider will wash your nose and septum with a germ-free (sterile) salt–water (saline) solution.
• A small drain will be put in your nose. Stitches (sutures) may be used to hold it in place.
• Gauze or bandage material (packing) will be put on both sides of your nose to stop bleeding.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• Do not drive for 24 hours if you received a sedative.
• You will be prescribed antibiotic medicine.
• The drain and packing will remain in your nose for 2–3 days until your health care provider has you return to have them removed.

Septal Hematoma Drainage, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild bleeding.
• Pain and swelling in your nose.
• A headache or a feeling of pressure in your head.

Follow these instructions at home:

Medicine

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Take your antibiotic medicine as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Nose Care

• Wear the packing as told by your health care provider. This can make your throat sore and dry. If this happens, try using a humidifier at night. You may need to wear a drip pad under your nose. Change the drip pad as told by your health care provider.
• Raise (elevate) your head with several pillows when you are sleeping or resting.
• Sneeze through your mouth. Do not sneeze through your nose.
• Do not blow your nose until your health care provider approves.

Lifestyle

• Do not eat or drink anything that is very hot as told by your health care provider. Eat mostly cool, soft foods.
• Drink 6–8 glasses of clear fluids every day.
• Do not drink alcohol.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.

Activity

• Rest as told by your health care provider. Ask your health care provider when you can return to your normal activities.
• Do not bend over or lift anything heavy.

General instructions

• Keep your packing dry.
• Do not take a bath or shower until your health care provider approves. Take sponge baths instead.
• Keep all follow-up visits as told by your health care provider. This is important.
• Do not drive for 24 hours if you received a sedative.

Contact a health care provider if:

• You need to change your drip pad more than every 15 minutes.
• Medicine does not help your pain.
• You have a fever.
• The pain and swelling in your nose get worse.
• The packing starts to fall out.

Get help right away if:

• Bleeding from your nose suddenly gets worse or you have blood in the back of your throat.
• You have swelling or pain around your eyes.
• Your eyesight changes.
• You have a very bad headache.
• You feel dizzy.
• You vomit.