Background: Nasal packing is frequently used after nasal surgeries to control bleeding and prevent adhesions. Many absorbable packing materials have been developed to avoid the drawbacks of the traditional non-absorbable ones and help in wound healing.
Objectives: This study was done to compare between absorbable and non-absorbable nasal packings regarding patient satisfaction and clinical outcome.
Patients and methods: A prospective,single-blinded, randomized controlled clinical study was carried out in Benha University Hospital from May 2018 to November 2019. 40 patients (80 nostrils) were enrolled in this study undergoing surgery. At the end of the procedure, the operative cavity of each patient was randomly packed with Merocel as a non-absorbable material on one side, and an absorbable material, which was sinufoam or gelfoam, on the other side. Patients’ symptoms including pain, nasal obstruction and nasal discharge were evaluated with a visual analogue scale. Objective findings about bleeding, crustations, adhesions, infection and mucosal oedema were evaluated endoscopically. Each evaluation was done at 3rd day, 2weeks, 4 weeks, 6 weeks, 12 weeks after surgery.
Results: Absorbable packings had minimal pain, nasal obstruction scores and lower incidence of discharge. Bleeding was significantly higher on absorbable side early postoperative especially with Gelfoam. Crustations and adhesions scores were significantly higher on Merocel packed sides. Gelfoam showed crustations and adhesions more than Sinufoam. Mucosal oedema score was significantly higher in Merocel group than the absorbable. However, there was no difference at 6&12weeks. Gelfoam showed only significantly higher oedema than Sinufoam at 6 weeks. There was a significant difference between absorbable group and Merocel regarding infection at 1&2 weeks. No difference between Gelfoam and Sinufoam regarding infection except at 6 weeks.
Conclusion: Absorbable packings are associated with less discomfort, more bleeding and fewer complications.
Abbreviation: CMC, CT, SMR, FESS,VAS,BS,AS,CS,MES, I&D. |
