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At least 19 recordsLinked to original sources
PubMed1999

Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

To examine the effects of single-dose dexamethasone use on edema, ecchymosis, and intraoperative bleeding in rhinoplasty, a double-blind, randomized trial with placebo control was planned. A total of 55 consecutive patients were included in the study. The dexamethasone (10 mg) was given intravenously just before surgery (preoperative group, n=18) or at the end of surgery (postoperative group, n=20). In the placebo group, 17 patients received saline preoperatively or postoperatively. Intraoperative blood loss was recorded for each patient. Postoperative scoring of eyelid swelling and ecchymosis was begun after approximately 24 hours and lasted into postoperative day 9. Only for the first 2 days was the difference between steroid groups (preoperative and postoperative) and the placebo group statistically significant for a decrease in eyelid edema (p < 0.05). A statistically significant difference in upper eyelid ecchymosis for both preoperative and postoperative steroid groups versus the placebo group also existed in the first 2 days (p < 0.05). Preoperative or postoperative steroid administration had no influence on the ecchymosis of the lower eyelid. When the results of the preoperative and postoperative steroid groups were compared, no significant difference was detected between the two groups in either edema or ecchymosis. To determine whether steroid use shortened the recovery period, the days on which edema and ecchymosis reached a minimum level were compared among the groups; no statistically significant difference was found among them. Using single-dose dexamethasone preoperatively did not alter intraoperative blood loss. Use of single-dose dexamethasone (either preoperatively or postoperatively) in rhinoplasty has a significant effect in decreasing upper and lower eyelid edema and upper eyelid ecchymosis for the first 2 days when compared with a placebo group. However, the effect of dexamethasone was lost after the first 2 days, and its use did not shorten the recovery period.

Adult↗
PubMed2005

Which type of osteotomy for edema and ecchymosis: external or internal?

BACKGROUND: Osteotomy is one of the major parts of a rhinoplasty operation. Edema and ecchymosis most commonly appear as a result of this surgical manipulation. Different authors use different techniques to perform osteotomy. The external perforating approach and the internal continuous technique are the 2 main ways of doing osteotomy in rhinoplasty. In our study, we tried to compare the effects of these 2 techniques regarding edema and ecchymosis. MATERIAL AND METHODS: Two groups that consisted of 20 patients were studied. In group A, osteotomy was performed through an external route in a perforating fashion. In group B, the osteotomy was performed through an internal route and in a continuous fashion. The patients in each group were scored according to a visual scoring system that describes the site and extension of ecchymosis and degree of edema on the second and seventh days after the surgery. The scoring was made by 2 examiners blinded to the type of surgery. RESULTS: Edema scores were almost the same between the 2 groups on the second and seventh days after the surgery. Ecchymosis scores were the same between the groups on the seventh day. However, the score for ecchymosis on the second day is significantly less in the internal continuous technique (P < 0.05) when it is compared with the external technique. CONCLUSION: External and internal techniques of osteotomy almost give the same results regarding edema and ecchymosis, but the internal continuous technique shows a tendency to produce less ecchymosis on the second postoperative day.

Adult↗
PubMedDate not supplied

Comparison of low-dose subcutaneous heparin calcium and heparin sodium on ecchymosis formation.

Ecchymosis formation in patients receiving identical concentrations of heparin calcium or heparin sodium was compared in a double-blind study. Sixty-three patients admitted to a coronary-care unit with orders to receive heparin 5000 units subcutaneously every 12 hours were randomly assigned to receive either heparin calcium or heparin sodium. The drugs were administered identically. The presence and size of any ecchymosis were recorded by a single observer. The 44 patients on whom data were collected received 86 heparin sodium and 102 heparin calcium injections. While there were no difference between salts in the percentage of patients with documented ecchymosis , significantly more injection sites with ecchymosis were reported for the calcium salt. No significant difference was found in bruise size between the calcium and sodium salts of heparin. In a subgroup of patients who were not receiving other drugs known to prolong bleeding, there was no significant difference between the salts in the percentage of patients and injection sites with ecchymosis . The subcutaneous administration of heparin calcium resulted in significantly more injection sites with ecchymosis than did heparin sodium, but the size of the reported ecchymosis was not different between the two groups.

Aged↗
PubMed2005

Does creating a subperiosteal tunnel influence the periorbital edema and ecchymosis in rhinoplasty?

PURPOSE: The study goal was to determine whether creating a subperiosteal tunnel before lateral osteotomy had an effect on postoperative periorbital edema, ecchymosis, and subconjunctival ecchymosis. PATIENTS AND METHODS: Eighteen consecutive patients who underwent septorhinoplasty were included in the study. In all patients lateral osteotomies were carried out bilaterally, after creating a subperiosteal tunnel on a randomly chosen side and without creating a subperiosteal tunnel on the other side. The patients were seen on the second postoperative day, and a different surgeon who was unaware of the side with the periosteal tunnel determined the side of the face with more edema and ecchymosis. Subconjunctival ecchymosis was evaluated and recorded, as well. RESULTS: Creating subperiosteal tunnels before lateral osteotomy statistically increased periorbital ecchymosis. Although there was no statistically significant difference, creating subperiosteal tunnels also increased development and severity of subconjunctival ecchymosis and edema. CONCLUSIONS: We suggest performing lateral osteotomy without creating subperiosteal tunnels.

Adolescent↗
PubMed2003

Effect of steroids on edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

A double-blind, randomized study was designed to determine the efficacy of dexamethasone in decreasing periorbital edema and ecchymosis after rhinoplasty. Sixty rhinoplasty patients undergoing hump resection and lateral osteotomy were included in the study and were divided into 6 groups: group 1 (n = 10), single dose of 8 mg intravenous (IV) dexamethasone 1 hour before the operation; group 2 (n = 10), single dose of 8 mg IV dexamethasone at the beginning of the operation; group 3 (n = 10), 3 doses of 8 mg IV dexamethasone 1 hour before the operation, and 24 and 48 hours after the operation; group 4 (n = 10), 3 doses of 8 mg IV dexamethasone at the beginning of the operation, and 24 and 48 hour after the operation; group 5 (n = 10), 3 doses of 8 mg IV dexamethasone immediately after the operation, and 24 and 48 hours after the operation; group 6 (n = 10), control, no dexamethasone administration before or after the operation. Intraoperative blood loss was recorded for each patient. Patients were evaluated at 24 hours and days 2, 5, 7, and 10. For the postoperative evaluation of periorbital ecchymosis and edema, a scale of 0 to 4 points was used. There was no significant difference between groups in terms of bleeding (P > 0.05). In the groups using steroid before osteotomy, edema and ecchymosis were significantly lower during the first 2 days compared with the control group (P < 0.05). No significant difference was seen between groups 1 and 2. When patients were evaluated on day 5, edema and ecchymosis were significantly lower in groups 3 and 4 (P < 0.05) compared with other groups, but there was no difference between them. Group 5 had a significantly higher level of edema and ecchymosis compared with groups 1 through 4 at 24 hours and at days 2, 5, and 7 (P > 0.05). There was no significant difference between groups on day 10. In conclusion, if the first dose is given before osteotomy, triple-dose steroid application is the best bet for decreasing postoperative edema and ecchymosis. None of the patients had any complications related to the use of dexamethasone.

Aged↗
PubMed2001

Subconjunctival ecchymosis due to rhinoplasty.

Orbital complications of rhinoplasty show a wide range from minor complications like periorbital edema and ecchymosis to severe complications like blindness. Also, subconjunctival ecchymosis is one of the orbital complications due to rhinoplasty. A prospective study was set out to assess the incidence and progression of subconjunctival ecchymosis and to find out mechanisms of this complication. The incidence of subconjunctival ecchymosis was found to be 19.1%. Typically it appeared unilaterally or bilaterally over the temporal subconjunctival area in the first two days after the operation. Complete resolution of subconjunctival ecchymosis took approximately 11 +/- 3 days. No other ocular symptoms were found. Subconjunctival ecchymosis only prolonged the recovery period of the patient from the rhinoplasty.

Conjunctival Diseases↗
PubMed2002

[Ecchymosis associated with the use of fluoxetine: case report].

UNLABELLED: Selective Serotonin Reuptake Inhibitors (SSRI) are well established in psychopharmacological therapy. SSRIs have been shown to be very effective in the treatment of depressive, anxiety and obsessive-compulsive disorders and have a favorable side effect profile. Although bleeding events are rare, there may be potentially severe hematologic complications following treatment with SSRIs. Fluoxetine has been reported to cause ecchymosis, bleeding and other hematologic problems. The aim of this article is to report a case of suspected fluoxetine-induced ecchymosis and to review the literature about this adverse effect. CASE SUMMARY: A 23-year-old woman was diagnosed with depressive disorder according to DSM-IV criteria and treated with fluoxetine 20 mg/day. After treatment for 10 weeks, the patient reported ecchymosis without any trauma. Her complete blood cell count, prothrombin time, partial thromboplastin time, bleeding time and other hematologic screening tests were within the normal limits. Her complete physical examination was also normal. After the medication was discontinued for 4 weeks, ecchymosis disappeared. A month later, the patient took fluoxetine for a week, and then the ecchymosis restarted. Fluoxetine was suspected to be the cause of these lesions. SSRIs cause these side effects by disrupting the normal platelet aggregation process through the blockade of serotonin uptake into platelets. For this reason, caution is recommended when using fluoxetine and other SSRIs in patients with thrombocytopenia or suspected platelet dysfunction.

English Abstract↗
PubMed1994

Effects of steroids on mood, edema, and ecchymosis in facial plastic surgery.

OBJECTIVE: To examine the effects of oral postoperative steroid therapy in facial plastic surgery on mood, edema, and ecchymosis. DESIGN: Double-blind randomized trial with placebo control. SETTING: Private practice, ambulatory care facility. PATIENTS: Any patient who was to undergo a procedure in which we had previously been employing postoperative steroid therapy was a potential participant. Any patient with known contraindications to steroid use was excluded. A consecutive, volunteer sample of 60 of 65 patients approached agreed to participate. Five patients of the 60 who participated were excluded from the final results owing to either study or participant errors, leaving a total sample of 55 patients. All 55 patients completed the study in the 7-day follow-up period. No patients were withdrawn owing to adverse effects. INTERVENTION: Taper of prednisone therapy from 60 mg orally and decreasing by 10 mg each day over a total of 6 days. MAIN OUTCOME MEASURES: Mood, edema, and ecchymosis. RESULTS: No significant differences were noted in mood, edema, or ecchymosis between the placebo and intervention groups. The study observer was blinded to patient groupings in the subjective measures of edema and ecchymosis. The patients rated any changes in mood and were also blinded to the group in which they belonged. CONCLUSIONS: The use of oral steroids given postoperatively in facial plastic surgery may be unnecessary and may subject the patient to undue risk. Further studies would be helpful to determine the potential benefit of steroids given in different dosages, routes, and timing in relation to the procedure.

Administration, Oral↗
PubMedDate not supplied

Effects of different corticosteroids on edema and ecchymosis in open rhinoplasty.

A double-blind, randomized trial with placebo control was planned to evaluate the effects of corticosteroids (betamethasone, dexamethasone, methylprednisolone) in approximately equivalent doses (8 mg dexamethasone/day), and to compare their effects with that of tenoxicam, an antiinflammatory drug, on both the edema and ecchymosis in open rhinoplasty with osteotomies. For this study, 40 patients were divided randomly into five groups of 8 patients each, which received, respectively, betamethasone (group 1), dexamethasone (group 2), methylprednisolone (group 3), tenoxicam (group 4), and placebo (group 5). Open rhinoplasty with osteotomies was performed by the same surgeon with the patient under general anesthesia. Drugs were administered just before the induction of anesthesia and continued for 3 days. Only acetaminophen was used to control postoperative analgesia. Digital photographs of each patient were taken on postoperative days 1, 3, and 7. Scoring was performed separately for eyelid swelling and ecchymosis by three observers independently using a graded scale from 0 to 4. No statistically significant differences existed among the five groups in terms of age, sex, duration of surgery, amount of bleeding, and intravenous fluid administration during the surgery. On postoperative days 1, 3, and 7, no differences in the levels of ecchymosis or edema among the steroid groups, the tenoxicam group, and the control groups were observed. In conclusion, the authors observed no significant differences among the different kinds of steroids administered in equivalent doses (8 mg dexamethasone/day). Steroids used in these doses were not effective in preventing or reducing edema and ecchymosis after open rhinoplasty with osteotomies. Tenoxicam also was not effective. No complications caused by the use of steroids were observed during the 6-month follow-up period.

Adult↗
PubMed1995

Effect of ketorolac tromethamine (Toradol) on ecchymosis following anterior cruciate ligament reconstruction.

This article describes a study that assesses whether patients who received ketorolac tromethamine (Toradol; Syntex Research, Palo Alto, California) during knee surgery had an increased tendency to develop ecchymosis in the lower limb versus patients who did not receive ketorolac tromethamine. Sixty-four patients who underwent anterior cruciate ligament (ACL) surgery were divided randomly into three groups: patients who received Toradol at tourniquet inflation (TorTourn) at the end of surgery (TorEnd), or not at all (TorNone). None of the patients exhibited abnormal preoperative bleeding times. One week postsurgery, patients were evaluated photographically for ecchymosis between the hip and malleoli of the surgical limb. Ecchymotic areas between the hip and malleoli were traced around their borders with a black marker. Three photographs of each surgical knee were taken: posterior, anterolateral, and anteromedial views. Each patient's photos then were scanned into a computer and the amount of encircled (ecchymotic) surface area and the total surface area of the limb were calculated. For each view, the ecchymotic surface area was divided by the total surface area to obtain a percentage of ecchymosis on that view. The percentages for the three views were added to obtain a single score for each patient. The mean ecchymotic surface area score was 21.9 +/- 31% for the TorTourn group, 27.5 +/- 25.5% for the TorEnd group, and 30.3 +/- 36.4% for the TorNone group. There was no significant difference in the ecchymotic surface area among the groups. This study suggests that ketorolac tromethamine does not affect the amount of ecchymosis that occurs following knee surgery.

Adolescent↗
PubMed1986

The plantar ecchymosis sign in fractures of the calcaneus.

The appearance of a central plantar ecchymosis is not an uncommon occurrence 24-48 hours after a compression fracture of the calcaneus. In order to understand the development of this characteristic ecchymosis, the authors studied the anatomy of the fascial compartments in five adult cadaveric feet. The anatomic basis for the plantar ecchymosis sign is demonstrated through dissection of the three osteofascial compartments within the sole of the foot. Dye injected into the central compartment overlying the calcaneal tuberosity reproduces the observed clinical sign. The specificity of this sign for compression fractures of the calcaneus makes it a useful clinical observation in cases where the diagnosis of fracture is uncertain.

Calcaneus↗
PubMed1990

Migraine associated with periorbital ecchymosis.

Two patients are reported who developed periorbital ecchymosis in association with migraine. The association is rare, having only been reported in the literature almost a century ago. The possible mechanism of the occurrence of periorbital ecchymosis in migraine is discussed.

Adult↗
PubMed1991

Safety-belt injuries in children with lap-belt ecchymosis: CT findings in 61 patients.

We have noted a complex of common injuries in children wearing lap-styled safety belts during vehicular accidents. Sixty-one children who were restrained passengers in motor vehicle crashes had linear ecchymosis across the abdomen and had CT for abdominal trauma. Thirteen children (21%) had a lumbar spine injury, and 14 children (23%) injured a hollow viscus (bowel, 12; bladder, two); five children (8%) had both spine and hollow viscus injuries. Abnormal findings on abdominal CT were recognized retrospectively in three of 13 children with lumbar spinal injury. Lateral radiographs of the spine showed lumbar spinal injury in all cases. Free intraperitoneal air was noted in on three (25%) of 12 children with bowel injury. In eight of those children, CT showed large, unexplained collections of peritoneal fluid. The presence of lap-belt ecchymosis should prompt a careful search for spine, bowel, and bladder injury. Recognition of the limitations of CT diagnosis of these injuries is important to reduce errors in interpretation.

Abdominal Injuries↗
PubMed1982

Scrotal ecchymosis: sign of intraperitoneal hemorrhage in the newborn.

Ecchymosis of the scrotum and lower abdominal wall occurred in four newborn boys. All were anemic. Three had coagulation abnormalities and evidence of sepsis. In two, group B streptococcal septicemia was documented. Intraperitoneal hemorrhage from a ruptured subcapsular hematoma of the liver was the source of blood in the scrotum in three, and most probably in the fourth as well. Two infants died in spite of antibiotics, vigorous blood replacement, including exchange transfusion, and desperation laparotomies for continued intraperitoneal hemorrhage. Newborns with scrotal ecchymosis should be examined for intraperitoneal hemorrhage, ruptured subcapsular hematoma of the liver being the most probable source. Their coagulation status should also be evaluated, and sepsis should be suspected, especially in those with a demonstrated coagulopathy. Group B Streptococcus is a likely primary etiologic agent in these critically ill neonates. Nonoperative treatment, as given the two survivors in this experience, is preferred.

Anti-Bacterial Agents↗
PubMed1989

Orbital hemorrhage and eyelid ecchymosis in acute orbital myositis.

We examined two patients with acute orbital myositis associated with orbital hemorrhage and eyelid ecchymosis. Both patients were young women (aged 22 and 30 years) who had painful proptosis, diplopia, and computed tomographic evidence of single extraocular muscle involvement with spillover of inflammatory edema into the adjacent orbital fat. Patient 1 showed contralateral preseptal eyelid inflammation and did not suffer an orbital hemorrhage until after an episode of vomiting. In Patient 2, the diagnosis of occult orbital varix was initially considered but an orbital exploration and a biopsy specimen showed no vascular anomaly. Both patients were treated successfully with high-dose systemic corticosteroids. Some cases of idiopathic orbital inflammation may be related to preexisting vascular anomalies or orbital phlebitis.

Acute Disease↗
PubMed2000

Trigeminal autonomic cephalgia with periorbital ecchymosis, ocular hemorrhage, hypertension and behavioral alterations.

We describe a 38-year-old male in whom severe unilateral headache was associated with marked palpebral edema, periorbital ecchymosis, lacrimation, conjunctival injection, nasal congestion and rhinorrhea. A second, less severe headache form developed subsequently. The patient often presented severe labile hypertension and behavioral disturbances during the crises, and there was an episode of intra-ocular hemorrhage. General, neurological and ophthalmological examinations revealed nothing remarkable. We discuss possible pathogenetic mechanisms and the nosology of this case within the trigeminal autonomic cephalgias.

Adult↗
PubMed1996

Recurrent paroxysmal headache associated with facial ecchymosis.

The case of a 58-year-old man with chronic paroxysmal headache and facial ecchymosis is described. The headache was pulsating, of short duration, without nausea or vomiting, and occasionally associated with flashing lights. Ecchymoses were mainly located in the middle forehead region and their appearance was associated with a reduction in intensity of the headache. Blood coagulation tests were within normal limits, and a skin biopsy of the ecchymotic lesion ruled out an underlying vasculitis. These attacks were difficult to include in any particular type of headache, although some aspects were similar to migraine headache. The possible mechanism of hemorrhages is discussed.

Basilar Artery↗