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Article Type

Article

Abstract

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 nonabsorbable ones and to help in wound healing.

Objective: This study was done to compare between absorbable and nonabsorbable 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. A total of 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 nonabsorbable 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 analog scale. Objective findings about bleeding, crustations, adhesions, infection, and mucosal edema were evaluated endoscopically. Each evaluation was done at third day, 2 weeks, 4 weeks, 6 weeks, and 12 weeks after surgery.

Results: Absorbable packings had minimal pain, less nasal obstruction scores, and lower incidence of discharge. Bleeding was significantly higher on absorbable side early postoperatively, especially with Gelfoam. Crustation and adhesion scores were significantly higher on Merocel‑packed sides.
Gelfoam showed crustations and adhesions more than Sinufoam. Mucosal edema score was significantly higher in Merocel group than the absorbable. However, there was no difference at 6 and 12 weeks. Gelfoam showed only significantly higher edema than Sinufoam at 6 weeks. There was a significant difference between absorbable group and Merocel regarding infection at 1 and 2 weeks.
There was 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.

Keywords: Absorbable packings, gelfoam, nasal surgeries, and sinufoam.

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