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Effectiveness of Polyvinyl Acetate Sheeted with Carboxymethyl Cellulose as a Packing Material after Septoplasty

비중격성형술 후 Carboxymethyl Cellulose 시트로 둘러싼 Polyvinyl Acetate의 비 패킹 재료로서 유용성

  • Kim, Sung-Dong (Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital) ;
  • Kim, Dongwon (Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital) ;
  • Kim, Deok-Soo (Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital) ;
  • Kim, Ji-a (Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital) ;
  • Lee, Dong-Joo (Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital) ;
  • Cho, Kyu-Sup (Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital)
  • 김성동 (부산대학교 의학전문대학원 부산대학교병원 이비인후과학교실) ;
  • 김동원 (부산대학교 의학전문대학원 부산대학교병원 이비인후과학교실) ;
  • 김덕수 (부산대학교 의학전문대학원 부산대학교병원 이비인후과학교실) ;
  • 김지아 (부산대학교 의학전문대학원 부산대학교병원 이비인후과학교실) ;
  • 이동주 (부산대학교 의학전문대학원 부산대학교병원 이비인후과학교실) ;
  • 조규섭 (부산대학교 의학전문대학원 부산대학교병원 이비인후과학교실)
  • Received : 2018.02.12
  • Accepted : 2018.08.25
  • Published : 2018.11.30

Abstract

Background and Objectives: Although polyvinyl acetate ($Merocel^{(R)}$) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet ($Rhinocel^{(R)}$) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty. Subjects and Method: Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with $Rhinocel^{(R)}$ and the other one with $Merocel^{(R)}$. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated. Results: Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, $Rhinocel^{(R)}$ was significantly more comfortable while in situ and less painful on removal than $Merocel^{(R)}$, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost. Conclusion: The use of $Rhinocel^{(R)}$ after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to $Merocel^{(R)}$ packing. Therefore, $Rhinocel^{(R)}$ may be a useful packing material after septoplasty.

Keywords

Acknowledgement

Supported by : Pusan National University Hospital

References

  1. Weber R, Hochapfel F, Draf W. Packing and stents in endonasal surgery. Rhinology 2000;38:49-62.
  2. Ozcan C, Vayisoglu Y, Kilic S, Gorur K. Comparison of rapid rhino and merocel nasal packs in endonasal septal surgery. J Otolaryngol Head Neck Surg 2008;37:826-31.
  3. Chandra RK, Kern RC. Advantages and disadvantages of topical packing in endoscopic sinus surgery. Curr Opin Otolaryngol Head Neck Surg 2004;12:21-6. https://doi.org/10.1097/00020840-200402000-00007
  4. von Schoenberg M, Robinson P, Ryan R. Nasal packing after routine nasal surgery-is it justified? J Laryngol Otol 1993;107:902-5. https://doi.org/10.1017/S0022215100124740
  5. Cho KS, Shin SK, Lee JH, Kim JY, Koo SK, Kim YW, et al. The efficacy of Cutanplast nasal packing after endoscopic sinus surgery: a prospective, randomized, controlled trial. Laryngoscope 2013;123:564-8. https://doi.org/10.1002/lary.23643
  6. Hajosch R, Suckfuell M, Oesser S, Ahlers M, Flechsenhar K, Schlosshauer B. A novel gelatin sponge for accelerated hemostasis. J Biomed Mater Res B Appl Biomater 2010;94:372-9.
  7. Cenni E, Ciapetti G, Stea S, Corradini A, Carozzi F. Biocompatibility and performance in vitro of a hemostatic gelatin sponge. J Biomater Sci Polym Ed 2000;11:685-99. https://doi.org/10.1163/156856200743959
  8. Cho KS, Park CH, Hong SL, Kim MJ, Kim JY, Kim YW, et al. Comparative analysis of Cutanplast and Spongostan nasal packing after endoscopic sinus surgery: a prospective, randomized, multicenter study. Eur Arch Otorhinolaryngol 2015;272:1699-705. https://doi.org/10.1007/s00405-014-3264-3
  9. Hong SL, Cho KS. Absorbable packing materials in the nasal cavity following sinonasal surgery. J Rhinol 2014;21:85-91.
  10. Banglawala SM, Gill M, Sommer DD, Psaltis A, Schlosser R, Gupta M. Is nasal packing necessary after septoplasty? A meta-analysis. Int Forum Allergy Rhinol 2013;3:418-24. https://doi.org/10.1002/alr.21110
  11. Dubin MR, Pletcher SD. Postoperative packing after septoplasty: is it necessary? Otolaryngol Clin North Am 2009;42:279-85. https://doi.org/10.1016/j.otc.2009.01.015
  12. Mehta U, Huber TC, Sindwani R. Patient expectations and recovery following endoscopic sinus surgery. Otolaryngol Head Neck Surg 2006;134:483-7. https://doi.org/10.1016/j.otohns.2005.10.053
  13. Valentine R, Wormald PJ, Sindwani R. Advances in absorbable biomaterials and nasal packing. Otolaryngol Clin North Am 2009;42:813-28. https://doi.org/10.1016/j.otc.2009.07.009
  14. Wee JH, Lee CH, Rhee CS, Kim JW. Comparison between Gelfoam packing and no packing after endoscopic sinus surgery in the same patients. Eur Arch Otorhinolaryngol 2012;269:897-903. https://doi.org/10.1007/s00405-011-1768-7
  15. Acioglu E, Edizer DT, Yigit O, Onur F, Alkan Z. Nasal septal packing: which one? Eur Arch Otorhinolaryngol 2012;269:1777-81. https://doi.org/10.1007/s00405-011-1842-1
  16. Chheda N, Katz AE, Gynizio L, Singer AJ. The pain of nasal tampon removal after nasal surgery: a randomized control trial. Otolaryngol Head Neck Surg 2009;140:215-7. https://doi.org/10.1016/j.otohns.2008.09.012
  17. Weber RK. Nasal packing and stenting. GMS Curr Top Otorhinolar yngol Head Neck Surg 2009;8:Doc02.
  18. Ohta S, Nishiyama T, Sakoda M, Machioka K, Fuke M, Ichimura S, et al. Development of carboxymethyl cellulose nonwoven sheet as a novel hemostatic agent. J Biosci Bioeng 2015;119:718-23. https://doi.org/10.1016/j.jbiosc.2014.10.026
  19. Szczygielski K, Rapiejko P, Wojdas A, Jurkiewicz D. Use of CMC foam sinus dressing in FESS. Eur Arch Otorhinolaryngol 2010;267:537-40. https://doi.org/10.1007/s00405-009-1117-2