Septoplasty is a surgical procedure performed to correct a deviated nasal septum, the wall of cartilage and bone separating the nasal passages. Following this surgery, the appearance of dried blood, mucus, and scabs, referred to as crusting, is an expected part of the healing process. The internal incisions and trauma from the operation generate this debris. Safely and gently removing this crusting promotes a smooth recovery and improves breathing, requiring specific post-operative techniques.
Timing the Start of Nasal Cleansing
Nasal cleansing often starts as early as the morning after the procedure, though the precise timing is determined by the operating surgeon. This initial stage is typically initiated once active bleeding has subsided. The goal of early, gentle rinsing is to prevent blood clots and mucus from hardening into obstructive crusts. You should have sterile saline solution and a low-pressure irrigation device, such as a squeeze bottle or Neti pot, ready, using only distilled, sterile, or previously boiled and cooled tap water for mixing the saline packets.
Saline Irrigation for Bulk Removal
Nasal irrigation is the most effective and safest method for clearing post-operative debris and softening the nasal lining. This process involves using a large volume of isotonic saline solution to gently flush the nasal passages. The mechanical action helps to loosen and carry away coagulated blood, mucus, and forming crusts without damaging the healing tissues.
To perform the irrigation correctly, lean over a sink with your head tilted slightly forward, keeping your mouth open to prevent pressure buildup in the ears. Insert the tip of the irrigation device into one nostril and squeeze gently, allowing the solution to flow across the nasal cavity and drain out the opposite nostril. The water temperature should be lukewarm to avoid startling the sensitive nasal membranes. Regular use, typically three to four times a day, maintains a moist environment conducive to faster healing and prevents stubborn obstructions.
Addressing Stubborn Crusting with Targeted Lubrication
While irrigation removes the bulk of the debris, dried blood adhering firmly to the internal walls or rim of the nostril requires a more targeted approach. This crusting can be softened and gently lifted using lubrication and a specialized technique. Begin by applying a prescribed antibiotic ointment, petroleum jelly, or sterile saline gel directly to the stubborn crusts near the nasal opening.
Allow the lubricant to sit for several minutes, giving the emollients time to penetrate and soften the hardened blood and mucus. Once softened, attempt targeted removal using a cotton-tipped swab moistened with water or diluted hydrogen peroxide, if approved by your doctor. The technique involves a gentle rolling motion to lift the crust away from the tissue, rather than scraping or digging. Avoid inserting the swab deeper than the cotton tip itself to prevent contact with the healing septum or internal suture lines.
Actions to Avoid and When to Contact Your Doctor
Several actions must be avoided during recovery to prevent bleeding, infection, or damage to the surgical repair. Do not blow your nose forcefully for at least one to two weeks, as the pressure created can disrupt the healing site and cause hemorrhage. Avoid inserting fingers or sharp instruments into the nose to pick at crusts, as this introduces bacteria and risks trauma to the septum. When you need to sneeze, always do so with your mouth open to equalize pressure and minimize strain on the nasal cavity.
Avoid activities that increase pressure in the head, such as heavy lifting, straining during bowel movements, or bending over for prolonged periods. While mild drainage is normal, contact your surgical team immediately if you experience heavy, bright red bleeding that does not stop with gentle pressure and rest. Other warning signs include a persistent fever above 101.5 degrees Fahrenheit, escalating pain, or the presence of a foul odor or thick, yellowish-green discharge, which may indicate a developing infection.