In some patients blood oozes submucosally (SM) and subcutaneously (SC), which appears as a bruise in the oral tissues on the face (Fig, 10-3), Blood in the subcutaneous tissues is known as ‘ecchvmosis. This is usually seen in older
patients because of their decreased tissue tone and weaker intercellular attachment. Ecchymosis is not dangerous and does not increase pain or infection. Patients, hower


er, should be warned that ecchymosis may occur, because if they awaken on the second postoperative day and see  bruising in the cheek or submandibular area, they maybecome very apprehensive about their progress. This anxiety is easily preventable by postoperative instructions.
Typically the onset of e chymosis is 2 to 4 days after surgery and usually resolves with 7 to 10 days.



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Radiology and endoscopy are the principal investigations. These are usually preceded by routine haematology and biochemistry. Plain

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