ear, nose, and throat disorders
How To Drain an Auricular Hematoma
Step by Step Description for Draining an Auricular Hematoma
Cleanse the pinna and adjacent skin with antiseptic solution. Anesthetize the pinna with 1%lidocainewithoutepinephrineusing an auricular block or direct infiltration around the hematoma. Topical anesthesia may be provided withlidocaine-prilocainecream in addition or as an alternative method. Incise the skin along the posterior edge of the hematoma using the #15 scalpel blade. Follow the curvature of the pinna in a skin crease or at the edge of a change in the cartilage shape to hide the scar. Gently separate the skin and overlying perichondrium from the hematoma and underlying cartilage using the hemostat or other tool. Evacuate the hematoma completely. Irrigate the hematoma pocket with sterile normal saline. Dry the area using gauze. Apply antibiotic ointment to the incision edge. Gently press the perichondrium back onto the cartilage with a finger; the pressure dressing will keep them in close proximity. Place dry cotton into the external auricular canal. Fill all external auricular crevices with petrolatum gauze or with dental rolls or gauze moistened with sterile saline ormineral oil. Hematomas that are both anterior and posterior require the bolsters to be sutured together with monofilament suture; dental rolls are particularly suited for this maneuver. Place several layers of gauze behind the ear to support the back of the ear against the pressure dressing. Cut a V-shape or curve out of the gauze first to allow for a close fit to the ear. Cover the external ear with multiple layers of fluffed-up 4×4 gauze, and hold them in place by wrapping elastic or gauze bandages around the head and taping the bottom edge of the dressing over the ear lobule. 